Provider Demographics
NPI:1568249183
Name:NOVALIZ DENTAL INC
Entity Type:Organization
Organization Name:NOVALIZ DENTAL INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:
Authorized Official - First Name:LISET
Authorized Official - Middle Name:MARIA
Authorized Official - Last Name:FRIAS FIGUEREDO
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:281-865-5379
Mailing Address - Street 1:710 E 49TH ST UNIT 101
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33013-1966
Mailing Address - Country:US
Mailing Address - Phone:281-865-5379
Mailing Address - Fax:
Practice Address - Street 1:710 E 49TH ST UNIT 101
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33013-1966
Practice Address - Country:US
Practice Address - Phone:281-865-5379
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-09-08
Last Update Date:2023-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty
No1223E0200XDental ProvidersDentistEndodonticsGroup - Multi-Specialty
No1223P0300XDental ProvidersDentistPeriodonticsGroup - Multi-Specialty
No1223S0112XDental ProvidersDentistOral and Maxillofacial SurgeryGroup - Multi-Specialty
No1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Multi-Specialty