Provider Demographics
NPI:1699336495
Name:VELKO DIMOVICH DDS PLLC
Entity type:Organization
Organization Name:VELKO DIMOVICH DDS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:VELKO
Authorized Official - Middle Name:
Authorized Official - Last Name:DIMOVICH
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:586-979-6060
Mailing Address - Street 1:9001 15 MILE RD STE B
Mailing Address - Street 2:
Mailing Address - City:STERLING HEIGHTS
Mailing Address - State:MI
Mailing Address - Zip Code:48312-3621
Mailing Address - Country:US
Mailing Address - Phone:586-979-6060
Mailing Address - Fax:586-979-6096
Practice Address - Street 1:9001 15 MILE RD STE B
Practice Address - Street 2:
Practice Address - City:STERLING HEIGHTS
Practice Address - State:MI
Practice Address - Zip Code:48312-3621
Practice Address - Country:US
Practice Address - Phone:586-979-6060
Practice Address - Fax:586-979-6096
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-06-24
Last Update Date:2019-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental