| NPI | 1942489570 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MATTHEW D PAVLICK President 330-678-6564 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2082S0099X Plastic Surgery Plastic Surgery Within the Head and Neck (Licence: OH 35.065469) |
| Additional Taxonomies | 204E00000X Oral & Maxillofacial Surgery (Licence: OH 35.065469) |
| Enumeration Date | 2007-10-31 |
| Last Update Date | 2014-03-19 |