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General NPI Number Information
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NPI Number | 1497267025
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Entity Type | Individual
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Provider Name | STEPHEN PAUL NOVAK DMD
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Gender | Male
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Dates
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Enumeration Date | 11/06/2017
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Last Update Date | 11/06/2017
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Provider Practice Location Address
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Address Line | 1200 YAMATO RD STE A4
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City | BOCA RATON
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State | FL
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Zip | 33431-4428
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Country | US
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Telephone | 561-997-9930
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Fax |
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Provider Business Mailing Address
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Address Line | 130 E 29TH CT
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City | RIVIERA BEACH
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State | FL
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Zip | 33404-2310
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Country | US
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Telephone | 954-298-7755
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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 | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | DN23031
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License Number State | FL
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