Organization
COLUMBUS PEDIATRIC DENTISTRY, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PROF. MARVIN V PAVLOV J.D. (C.E.O.)
(812) 376-0166
Entity
Organization
Contact information
Practice address
3158 N NATIONAL RD, COLUMBUS, IN 47201-3170
(812) 376-0166
Mailing address
3158 N NATIONAL RD, COLUMBUS, IN 47201-3170
(812) 376-0166
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
—
—
Other
Enumeration date
05/16/2007
Last updated
08/22/2020
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