Provider Demographics
NPI:1003337536
Name:SABOVICH, DAVID JONATHON (DMD)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:JONATHON
Last Name:SABOVICH
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 1:7550 HIGHLAND HILLS DR
Mailing Address - Street 2:
Mailing Address - City:ELGIN
Mailing Address - State:OK
Mailing Address - Zip Code:73538-2370
Mailing Address - Country:US
Mailing Address - Phone:805-704-1582
Mailing Address - Fax:
Practice Address - Street 1:6037 BESSINGER ST
Practice Address - Street 2:
Practice Address - City:FORT SILL
Practice Address - State:OK
Practice Address - Zip Code:73503-4406
Practice Address - Country:US
Practice Address - Phone:580-442-0175
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-07-06
Last Update Date:2022-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZD009740122300000X, 1223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics
No122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
1003337536OtherNPPES