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General NPI Number Information
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NPI Number | 1164874962
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Entity Type | Individual
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Provider Name | ELIZABETA COKOVSKA DMD; PROSTHODONTIST
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Gender | Female
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Dates
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Enumeration Date | 07/06/2016
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Last Update Date | 07/06/2016
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Provider Practice Location Address
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Address Line | 180 PINNACLES DR
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City | PALM COAST
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State | FL
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Zip | 32164-2596
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Country | US
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Telephone | 386-437-5253
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Fax |
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Provider Business Mailing Address
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Address Line | 1391 CHAPARRAL LN
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City | WINTER SPRINGS
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State | FL
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Zip | 32708-4853
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Country | US
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Telephone | 407-965-9967
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Fax |
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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 | 1223P0700X
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Taxonomy Name | Prosthodontics
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License Number | 21687
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License Number State | FL
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