Provider Demographics
NPI:1457363509
Name:STEFANOVIC, NENAD B (DDS,MSD)
Entity Type:Individual
Prefix:DR
First Name:NENAD
Middle Name:B
Last Name:STEFANOVIC
Suffix:
Gender:M
Credentials:DDS,MSD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2701 N OCEAN BLVD
Mailing Address - Street 2:# 14 E
Mailing Address - City:FORT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33308-7575
Mailing Address - Country:US
Mailing Address - Phone:954-567-2941
Mailing Address - Fax:954-567-2941
Practice Address - Street 1:4330 SHERIDAN ST
Practice Address - Street 2:SUITE #201 A
Practice Address - City:HOLLYWOOD
Practice Address - State:FL
Practice Address - Zip Code:33021-1407
Practice Address - Country:US
Practice Address - Phone:954-961-3939
Practice Address - Fax:954-961-5536
Is Sole Proprietor?:No
Enumeration Date:2006-08-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN 139821223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics