Organization
DRS. PAVLICK AND REPPAS, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MATTHEW D PAVLICK DDS MD (PRESIDENT)
(330) 678-6564
Entity
Organization
Contact information
Practice address
571 BOSTON MILLS RD, HUDSON, OH 44236-1164
(330) 655-9700
(330) 342-9847
Mailing address
571 BOSTON MILLS RD, HUDSON, OH 44236-1164
(330) 655-9700
(330) 342-9847
Taxonomy
Speciality
Code
Description
License number
State
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
35.065469
OH
2082S0099X
Plastic Surgery Within the Head and Neck (Plastic Surgery) Physician
Primary
35.065469
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0743902
PTAN
OH
Enumeration date
10/31/2007
Last updated
03/19/2014
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