Individual
MRS. VIVIANA VAGALAU PAWLICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
220 W GARFIELD AVE, CHARLEVOIX, MI 49720-1631
(231) 547-6523
(231) 547-6238
Mailing address
8998 GAUNT RD, EAST JORDAN, MI 49727-8646
(231) 536-9606
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
2901018274
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4800808
—
MI
Enumeration date
01/22/2007
Last updated
07/08/2007
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