MEDICARE: SVETA NOVAK D.M.D

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	18427	MA

General Provider Information

NPI Number	:	1902092448
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SVETA NOVAK D.M.D

Provider Business Mailing Address
First Line	:	16 BARROWS ST
Second Line	:
City	:	NORTH ATTLEBORO
State	:	MA
Zip	:	02760-2242
Country	:	US
Telephone Number	:	508-695-3719
Fax Number	:	508-695-0237

Provider Business Practice Location Address
First Line	:	16 BARROWS ST
Second Line	:
City	:	NORTH ATTLEBORO
State	:	MA
Zip	:	02760-2242
Country	:	US
Telephone Number	:	508-695-3719
Fax Number	:	508-695-0237

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

Provider Enumeration Date	:	09/19/2007
Last Update Date	:	09/19/2007

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