Provider Demographics
NPI:1447768015
Name:PAVLIK, JOELL ANN (PHDHP)
Entity type:Individual
Prefix:
First Name:JOELL
Middle Name:ANN
Last Name:PAVLIK
Suffix:
Gender:F
Credentials:PHDHP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:115 FAIRVIEW DR
Mailing Address - Street 2:
Mailing Address - City:IRWIN
Mailing Address - State:PA
Mailing Address - Zip Code:15642-8900
Mailing Address - Country:US
Mailing Address - Phone:724-863-3352
Mailing Address - Fax:
Practice Address - Street 1:807 WALLACE AVE
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15221-2312
Practice Address - Country:US
Practice Address - Phone:412-242-0584
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-01-17
Last Update Date:2018-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPHDH000833124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist