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General NPI Number Information
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NPI Number | 1104971951
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Entity Type | Individual
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Provider Name | MATTHEW WILLIAM PAWLICK DDS
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Gender | Male
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Dates
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Enumeration Date | 01/24/2007
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Last Update Date | 10/30/2024
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Provider Practice Location Address
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Address Line | 220 W GARFIELD AVE
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City | CHARLEVOIX
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State | MI
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Zip | 49720-1631
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Country | US
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Telephone | 231-547-6523
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Fax | 231-547-6238
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Provider Business Mailing Address
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Address Line | 3434 M 119 STE G
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City | HARBOR SPRINGS
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State | MI
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Zip | 49740-9373
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Country | US
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Telephone | 231-348-3970
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Fax | 231-373-5177
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 18239
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License Number State | MI
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