Provider Demographics
NPI:1225241425
Name:HARVEY L NOVACK DMD PC
Entity Type:Organization
Organization Name:HARVEY L NOVACK DMD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:HARVEY
Authorized Official - Middle Name:LEON
Authorized Official - Last Name:NOVACK
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:508-339-3300
Mailing Address - Street 1:100 COPELAND DRIVE
Mailing Address - Street 2:SUITE 10
Mailing Address - City:MANSFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:02048
Mailing Address - Country:US
Mailing Address - Phone:508-339-3300
Mailing Address - Fax:508-337-6096
Practice Address - Street 1:100 COPELAND DRIVE
Practice Address - Street 2:SUITE 10
Practice Address - City:MANSFIELD
Practice Address - State:MA
Practice Address - Zip Code:02048
Practice Address - Country:US
Practice Address - Phone:508-339-3300
Practice Address - Fax:508-337-6096
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-07
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223E0200XDental ProvidersDentistEndodonticsGroup - Single Specialty