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NPI Code Detail

MEDICARE: PAWLUS DENTAL INC

MEDICARE: PAWLUS DENTAL INC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1122300000XDentist12009682AIN

General Provider Information

NPI Number : 1013134212
Entity Type Code : Organization
Provider Name (Legal Business Name) : PAWLUS DENTAL INC
Provider Business Mailing Address
First Line : 4001 W GOELLER BLVD STE C
Second Line :
City : COLUMBUS
State : IN
Zip : 47201-8309
Country : US
Telephone Number : 812-372-8590
Fax Number : 812-372-8934
Provider Business Practice Location Address
First Line : 4001 W GOELLER BLVD STE C
Second Line :
City : COLUMBUS
State : IN
Zip : 47201-8309
Country : US
Telephone Number : 812-372-8590
Fax Number : 812-372-8934
Authorized Official
Title or Position : PRESIDENT
Name : MR. JOHN G PAWLUS
Credential : DDS
Telephone Number : 812-372-8590
Provider Enumeration Date : 04/19/2007
Last Update Date : 02/07/2013

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Directions to “PAWLUS DENTAL INC ” Practice Location

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