Organization
WILLIAM J. PAVLISIN, D.D.S., P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. WILLIAM JOHN PAVLISIN DDS (OWNER)
(314) 481-5150
Entity
Organization
Contact information
Practice address
9021 GRAVOIS RD, SAINT LOUIS, MO 63123-4625
(314) 481-5150
(314) 481-5150
Mailing address
9021 GRAVOIS RD, SAINT LOUIS, MO 63123-4625
(314) 481-5150
(314) 481-5150
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
—
—
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
13525144
CAQH
—
Enumeration date
01/14/2019
Last updated
01/14/2019
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