Pavolotsky, Konstantin

Pavolotsky, Konstantin is an individual health care provider with primary practice located at 6028 Mayfield Rd Suite 8, Mayfield Heights OH 44124. He recently has only one registered license in Dental Providers / Dentist, which is considered as his primary health care specialty. Pavolotsky, Konstantin can be contacted via phone (440) 684-9424.

Contact Information

Primary practice address
6028 Mayfield Rd Suite 8 Mayfield Heights OH 44124
Phone: (440) 684-9424
Fax: (440) 684-0126
Website:
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Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Dentist 122300000X 30 020384 Ohio
Dental Providers / Dentist 122300000X 12009774A Indiana

Profile Details

NPI number 1407864259
LBN Legal business name Pavolotsky, Konstantin
Credentials Doctor of Dental Surgery (DDS)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 4th, 2006
Last updated Jul 8th, 2007 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1407864259 NPPES
Ohio MEDICAID 0194178

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