Provider Demographics
NPI:1265648869
Name:DAVID A. KOVACH, DDS, PC
Entity Type:Organization
Organization Name:DAVID A. KOVACH, DDS, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:A
Authorized Official - Last Name:KOVACH
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:276-322-4023
Mailing Address - Street 1:517 TAZEWELL AVE
Mailing Address - Street 2:P.O. BOX 847
Mailing Address - City:BLUEFIELD
Mailing Address - State:VA
Mailing Address - Zip Code:24605
Mailing Address - Country:US
Mailing Address - Phone:276-322-4023
Mailing Address - Fax:276-322-4023
Practice Address - Street 1:517 TAZEWELL AVE
Practice Address - Street 2:
Practice Address - City:BLUEFIELD
Practice Address - State:VA
Practice Address - Zip Code:24605-1724
Practice Address - Country:US
Practice Address - Phone:276-322-4023
Practice Address - Fax:276-322-4023
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-14
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VAVA0401003865122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty