| Nova Dental Incorporated | |
|
4411 E 5th St Suite D Tucson AZ 85711-2015 | |
| (520) 325-1098 | |
| (520) 325-1112 |
| Full Name | Nova Dental Incorporated |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 4411 E 5th St, Tucson, Arizona |
| Authorized Official Name and Position | Suo Ji (PRESIDENT) |
| Authorized Official Contact | 5203251098 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Nova Dental Incorporated 4411 E 5th St Suite D Tucson AZ 85711-2015 Ph: (520) 325-1098 | Nova Dental Incorporated 4411 E 5th St Suite D Tucson AZ 85711-2015 Ph: (520) 325-1098 |
| NPI Number | 1891121422 |
|---|---|
| Provider Enumeration Date | 09/14/2013 |
| Last Update Date | 09/14/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1891121422 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | D6339 (Arizona) | Primary |
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