Provider Demographics
NPI:1588402473
Name:JAMES J BUKOVAC DDS PLLC
Entity type:Organization
Organization Name:JAMES J BUKOVAC DDS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:J
Authorized Official - Last Name:BUKOVAC
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:757-631-9700
Mailing Address - Street 1:3933 BONNEY RD
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23452-2445
Mailing Address - Country:US
Mailing Address - Phone:757-631-9700
Mailing Address - Fax:757-631-9571
Practice Address - Street 1:3933 BONNEY RD
Practice Address - Street 2:
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23452-2445
Practice Address - Country:US
Practice Address - Phone:757-631-9700
Practice Address - Fax:757-631-9571
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-07-16
Last Update Date:2024-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty