Individual
MRS. KENDRA RUTH PAVLIK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.D.S
Contact information
Practice address
2670 33RD AVE, COLUMBUS, NE 68601-1315
(402) 564-7575
(402) 564-1818
Mailing address
2765 EASTBROOK DR, COLUMBUS, NE 68601-1981
(402) 562-7775
(402) 564-1818
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
6533
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
10025277900
—
NE
Enumeration date
12/07/2006
Last updated
07/08/2007
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