Provider Demographics
NPI:1700035326
Name:DUZDEVICH, VELEBIT PEREZ (DMD)
Entity Type:Individual
Prefix:DR
First Name:VELEBIT
Middle Name:PEREZ
Last Name:DUZDEVICH
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:53 W 72ND ST
Mailing Address - Street 2:PROSMILE, 2ND FLOOR
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10023-3459
Mailing Address - Country:US
Mailing Address - Phone:212-799-8040
Mailing Address - Fax:212-799-8190
Practice Address - Street 1:53 W 72ND ST
Practice Address - Street 2:PROSMILE, 2ND FLOOR
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10023-3459
Practice Address - Country:US
Practice Address - Phone:212-799-8040
Practice Address - Fax:212-799-8190
Is Sole Proprietor?:No
Enumeration Date:2008-09-18
Last Update Date:2008-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY043159-1122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist