Individual
JOHN J PAVLICEK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
834 SW 11TH ST, REDMOND, OR 97756-0404
(541) 504-0880
(541) 504-9956
Mailing address
834 SW 11TH ST, REDMOND, OR 97756-0404
(541) 504-0880
(541) 504-9956
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D4356
OR
Other
Enumeration date
05/09/2007
Last updated
07/08/2007
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