Provider Demographics
NPI:1316199425
Name:KOVAL & KOVAL DENTAL ASSOC, INC.
Entity Type:Organization
Organization Name:KOVAL & KOVAL DENTAL ASSOC, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CHRISTINE
Authorized Official - Middle Name:L
Authorized Official - Last Name:KOVAL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:941-923-5406
Mailing Address - Street 1:2477 STICKNEY POINT ROAD
Mailing Address - Street 2:#216A
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34231
Mailing Address - Country:US
Mailing Address - Phone:941-923-5406
Mailing Address - Fax:941-923-0741
Practice Address - Street 1:2477 STICKNEY POINT ROAD
Practice Address - Street 2:#216A
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34231
Practice Address - Country:US
Practice Address - Phone:941-923-5406
Practice Address - Fax:941-923-0741
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-21
Last Update Date:2008-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN9651122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty