Provider Demographics
NPI:1972676310
Name:DIMOVICH, VELKO (DDS)
Entity Type:Individual
Prefix:DR
First Name:VELKO
Middle Name:
Last Name:DIMOVICH
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 1:9001 15 MILE RD
Mailing Address - Street 2:STE B
Mailing Address - City:STERLING HEIGHTS
Mailing Address - State:MI
Mailing Address - Zip Code:48312-3611
Mailing Address - Country:US
Mailing Address - Phone:586-979-6060
Mailing Address - Fax:586-979-6096
Practice Address - Street 1:9001 15 MILE RD
Practice Address - Street 2:STE B
Practice Address - City:STERLING HEIGHTS
Practice Address - State:MI
Practice Address - Zip Code:48312-3611
Practice Address - Country:US
Practice Address - Phone:586-979-6060
Practice Address - Fax:586-979-6096
Is Sole Proprietor?:No
Enumeration Date:2006-11-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist