Provider Demographics
NPI:1972605160
Name:NOVACK, HOWARD JACK (DDS)
Entity Type:Individual
Prefix:DR
First Name:HOWARD
Middle Name:JACK
Last Name:NOVACK
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 1:800 SOLDIER HILL ROAD
Mailing Address - Street 2:
Mailing Address - City:ORADELL
Mailing Address - State:NJ
Mailing Address - Zip Code:07649-1203
Mailing Address - Country:US
Mailing Address - Phone:201-666-0475
Mailing Address - Fax:201-265-1643
Practice Address - Street 1:800 SOLDIER HILL RD
Practice Address - Street 2:
Practice Address - City:ORADELL
Practice Address - State:NJ
Practice Address - Zip Code:07649-1203
Practice Address - Country:US
Practice Address - Phone:201-666-0475
Practice Address - Fax:201-265-1643
Is Sole Proprietor?:No
Enumeration Date:2006-09-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ7128208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice