Provider Demographics
NPI:1447456298
Name:PAVLICK, KATHERINE POSIUSZNY (DDS)
Entity type:Individual
Prefix:DR
First Name:KATHERINE
Middle Name:POSIUSZNY
Last Name:PAVLICK
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4884 DRESSLER ROAD, N.W.
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:OH
Mailing Address - Zip Code:44718
Mailing Address - Country:US
Mailing Address - Phone:330-493-8197
Mailing Address - Fax:
Practice Address - Street 1:4884 DRESSLER ROAD, N.W.
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:OH
Practice Address - Zip Code:44718
Practice Address - Country:US
Practice Address - Phone:330-493-8197
Practice Address - Fax:412-928-0455
Is Sole Proprietor?:No
Enumeration Date:2007-06-26
Last Update Date:2011-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS0365821223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice