Provider Demographics
NPI:1982787370
Name:ROBERT J RIPICH & BRET PAVLICA DDS LLC
Entity Type:Organization
Organization Name:ROBERT J RIPICH & BRET PAVLICA DDS LLC
Other - Org Name:ROBERT J RIPICH DDS & ASSOCIATES
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:J
Authorized Official - Last Name:RIPICH
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:330-454-6621
Mailing Address - Street 1:PO BOX 80537
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:OH
Mailing Address - Zip Code:44708
Mailing Address - Country:US
Mailing Address - Phone:330-454-6621
Mailing Address - Fax:330-454-1555
Practice Address - Street 1:3054 W TUSCARAWAS STREET
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:OH
Practice Address - Zip Code:44708
Practice Address - Country:US
Practice Address - Phone:330-454-6621
Practice Address - Fax:330-454-1555
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-23
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH13348 DR RIPICH1223G0001X
OH20077 DR PAVLICA1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty