Provider Demographics
NPI:1982929899
Name:DAVID H.J. PAVASKO, DMD, P.C.
Entity type:Organization
Organization Name:DAVID H.J. PAVASKO, DMD, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:HOWARD
Authorized Official - Last Name:PAVASKO
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:724-327-5995
Mailing Address - Street 1:4810 OLD WILLIAM PENN HWY STE 4
Mailing Address - Street 2:
Mailing Address - City:EXPORT
Mailing Address - State:PA
Mailing Address - Zip Code:15632-9468
Mailing Address - Country:US
Mailing Address - Phone:724-327-5995
Mailing Address - Fax:724-327-3465
Practice Address - Street 1:4810 OLD WILLIAM PENN HWY STE 4
Practice Address - Street 2:
Practice Address - City:EXPORT
Practice Address - State:PA
Practice Address - Zip Code:15632-9468
Practice Address - Country:US
Practice Address - Phone:724-327-5995
Practice Address - Fax:724-327-3465
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-04-03
Last Update Date:2010-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS026704-L1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty