Provider Demographics
NPI:1215032693
Name:YAKOVICH, MILAN (DDS)
Entity Type:Individual
Prefix:MR
First Name:MILAN
Middle Name:
Last Name:YAKOVICH
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5851 PEARL RD STE 100
Mailing Address - Street 2:
Mailing Address - City:PARMA HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:44130-2112
Mailing Address - Country:US
Mailing Address - Phone:440-885-0038
Mailing Address - Fax:440-885-5611
Practice Address - Street 1:5851 PEARL RD STE 100
Practice Address - Street 2:
Practice Address - City:PARMA HEIGHTS
Practice Address - State:OH
Practice Address - Zip Code:44130-2112
Practice Address - Country:US
Practice Address - Phone:440-885-0038
Practice Address - Fax:440-885-5611
Is Sole Proprietor?:No
Enumeration Date:2006-09-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH17625122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist