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Individual

CARLOS HERNANDEZ PAVON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
305 W 12TH AVE FL 2, COLUMBUS, OH 43210-1267
(614) 292-2622
Mailing address
11802 REEDY CREEK DR APT 307, ORLANDO, FL 32836-6821
(407) 764-3698

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
RES.004849
OH
390200000X
Student in an Organized Health Care Education/Training Program

Other

Enumeration date
06/17/2024
Last updated
08/04/2024
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