MEDICARE: DR. DAVOR SEFEROVIC DMD, MPH

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	D012702	AZ
2	122300000X	Dentist	40484	TX

General Provider Information

NPI Number	:	1235973801
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DAVOR SEFEROVIC DMD, MPH

Provider Business Mailing Address
First Line	:	2450 E GUADALUPE RD STE 108
Second Line	:
City	:	GILBERT
State	:	AZ
Zip	:	85234-5116
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2450 E GUADALUPE RD STE 108
Second Line	:
City	:	GILBERT
State	:	AZ
Zip	:	85234-5116
Country	:	US
Telephone Number	:	480-750-4433
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/19/2024
Last Update Date	:	02/18/2026

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