Individual
DR. PAVEL IVANOV IVANOV
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Contact information
Practice address
12866 BISCAYNE BLVD, NORTH MIAMI, FL 33181-2007
(786) 540-1919
Mailing address
12866 BISCAYNE BLVD, NORTH MIAMI, FL 33181-2007
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
DN19160
FL
Other
Enumeration date
11/29/2012
Last updated
01/02/2020
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