Provider Demographics
NPI:1811725328
Name:DEMCZUR, PAVLO (DMD)
Entity type:Individual
Prefix:
First Name:PAVLO
Middle Name:
Last Name:DEMCZUR
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:USS GEORGE WASHINGTON (CVN-73)
Mailing Address - Street 2:UNIT 100148 BOX 2681
Mailing Address - City:FPO
Mailing Address - State:AP
Mailing Address - Zip Code:96607-4826
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:USS GEORGE WASHINGTON (CVN-73)
Practice Address - Street 2:
Practice Address - City:FPO
Practice Address - State:AE
Practice Address - Zip Code:09550
Practice Address - Country:US
Practice Address - Phone:315-243-8808
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-25
Last Update Date:2025-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22DI03035200122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist