Individual
VASILIOS JAMES PAVLAKOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
3904 JUAN TABO NE, ALBUQUERQUE, NM 87111
(505) 292-7526
(505) 292-1058
Mailing address
3904 JUAN TABO NE, ALBUQUERQUE, NM 87111
(505) 292-7526
(505) 292-1058
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
1448
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
008676
BCBS PROVIDER #
NM
01
—
681068
UNITED CONCORDIA PROVIDER
NM
Enumeration date
11/15/2006
Last updated
07/08/2007
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