Provider Demographics
NPI:1982740874
Name:DR. ROBERT M PAVALUNAS D.D.S. P.S.
Entity Type:Organization
Organization Name:DR. ROBERT M PAVALUNAS D.D.S. P.S.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:MERRITT
Authorized Official - Last Name:PAVALUNAS
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:253-833-9063
Mailing Address - Street 1:11033 SE 295TH ST
Mailing Address - Street 2:
Mailing Address - City:AUBURN
Mailing Address - State:WA
Mailing Address - Zip Code:98092-1902
Mailing Address - Country:US
Mailing Address - Phone:253-931-8257
Mailing Address - Fax:
Practice Address - Street 1:701 M ST NE STE 104
Practice Address - Street 2:
Practice Address - City:AUBURN
Practice Address - State:WA
Practice Address - Zip Code:98002-4500
Practice Address - Country:US
Practice Address - Phone:253-833-9063
Practice Address - Fax:253-833-9197
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-29
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA38461223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty