Individual
MIRO A PAVELKA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS, MSD
Contact information
Practice address
400 S COTTONWOOD DR, SUITE B, RICHARDSON, TX 75080-5708
(972) 231-6661
(972) 231-3161
Mailing address
400 S COTTONWOOD DR, SUITE B, RICHARDSON, TX 75080-5708
(972) 231-6661
(972) 231-3161
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
D11521
TX
Other
Enumeration date
03/21/2007
Last updated
07/09/2007
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