Provider Demographics
NPI:1952131864
Name:KOJIC, DAVE DARKO (DMD, MS, PHD)
Entity type:Individual
Prefix:DR
First Name:DAVE
Middle Name:DARKO
Last Name:KOJIC
Suffix:
Gender:M
Credentials:DMD, MS, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:800 W JEFFERSON ST
Mailing Address - Street 2:
Mailing Address - City:KIRKSVILLE
Mailing Address - State:MO
Mailing Address - Zip Code:63501-1443
Mailing Address - Country:US
Mailing Address - Phone:660-626-2875
Mailing Address - Fax:660-626-2812
Practice Address - Street 1:800 W JEFFERSON ST
Practice Address - Street 2:
Practice Address - City:KIRKSVILLE
Practice Address - State:MO
Practice Address - Zip Code:63501-1443
Practice Address - Country:US
Practice Address - Phone:660-626-2875
Practice Address - Fax:660-626-2812
Is Sole Proprietor?:No
Enumeration Date:2024-08-05
Last Update Date:2024-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO20240074421223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice