Provider Demographics
NPI:1184776148
Name:BOSKOVIC & SRBINOVSKA DDS INC
Entity type:Organization
Organization Name:BOSKOVIC & SRBINOVSKA DDS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MILOS
Authorized Official - Middle Name:M
Authorized Official - Last Name:BOSKOVIC
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:714-832-2672
Mailing Address - Street 1:13372 NEWPORT AVE
Mailing Address - Street 2:SUITE G
Mailing Address - City:TUSTIN
Mailing Address - State:CA
Mailing Address - Zip Code:92780-3426
Mailing Address - Country:US
Mailing Address - Phone:714-832-2672
Mailing Address - Fax:714-832-1607
Practice Address - Street 1:13372 NEWPORT AVE
Practice Address - Street 2:SUITE G
Practice Address - City:TUSTIN
Practice Address - State:CA
Practice Address - Zip Code:92780-3426
Practice Address - Country:US
Practice Address - Phone:714-832-2672
Practice Address - Fax:714-832-1607
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-18
Last Update Date:2015-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA312101223P0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0700XDental ProvidersDentistProsthodonticsGroup - Single Specialty