Individual
DR. HUGO PAVON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Contact information
Practice address
465 N 26TH ST, LOUISVILLE, KY 40212-1449
(502) 778-7678
Mailing address
3600 GLENFIELD CT, LOUISVILLE, KY 40241-2513
(502) 326-0789
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
6711
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
60067113
—
KY
Enumeration date
10/12/2005
Last updated
07/08/2007
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