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General NPI Number Information
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NPI Number | 1063687077
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Entity Type | Individual
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Provider Name | MILUTIN DRAKULOVIC D.D.S.
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Gender | Male
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Dates
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Enumeration Date | 04/30/2008
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Last Update Date | 03/15/2010
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Provider Practice Location Address
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Address Line | 711 E CAREFREE HWY STE 210
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City | PHOENIX
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State | AZ
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Zip | 85085-0101
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Country | US
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Telephone | 623-434-9868
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Fax | 623-434-9864
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Provider Business Mailing Address
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Address Line | 711 E CAREFREE HWY STE 210
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City | PHOENIX
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State | AZ
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Zip | 85085-0101
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Country | US
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Telephone | 623-434-9868
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Fax | 623-434-9864
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 2901016560
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 7739
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License Number State | AZ
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