Individual
PAVOL PORAZIK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S
Contact information
Practice address
7136 N ACADEMY BLVD, COLORADO SPRINGS, CO 80920
(415) 881-7256
Mailing address
7136 N ACADEMY BLVD, COLORADO SPRINGS, CO 80920-3185
(415) 881-7256
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
DDS102444
CA
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
DEN.00203697
CO
Other
Enumeration date
07/12/2012
Last updated
09/13/2019
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