Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223X0400X | Orthodontists | DS035194 | PA |
NPI | 1063850394 |
---|---|
Provider Name | Dr. Sarah S Pavlow |
First Address | Collegeville, PA 19426-1181 |
Second Address | Collegeville, PA 19426-3622 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/06/2013 |
Last Update Date | 14/03/2021 |