Individual
DR. KONSTANTIN PAVOLOTSKY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
6028 MAYFIELD RD, SUITE 8, MAYFIELD HEIGHTS, OH 44124
(440) 684-9424
(440) 684-0126
Mailing address
6028 MAYFIELD RD, SUITE 8, MAYFIELD HEIGHTS, OH 44124
(440) 684-9424
(440) 684-0126
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
12009774A
IN
122300000X
Dentist
Primary
30 020384
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0194178
—
OH
Enumeration date
08/04/2006
Last updated
07/08/2007
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