Provider Demographics
NPI:1942226998
Name:NOVAKOVIC, DONALD V (DDS)
Entity Type:Individual
Prefix:DR
First Name:DONALD
Middle Name:V
Last Name:NOVAKOVIC
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3535 W OKLAHOMA AVE
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53215-4171
Mailing Address - Country:US
Mailing Address - Phone:414-384-4220
Mailing Address - Fax:414-384-4230
Practice Address - Street 1:3535 W OKLAHOMA AVE
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53215-4171
Practice Address - Country:US
Practice Address - Phone:414-384-4220
Practice Address - Fax:414-384-4230
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI5000-334-0151223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice