Provider Demographics
NPI:1144492836
Name:DEBORAH F. NOVAK,DDS,PA
Entity type:Organization
Organization Name:DEBORAH F. NOVAK,DDS,PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ORTHODONTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:DEBORAH
Authorized Official - Middle Name:FRAZIER
Authorized Official - Last Name:NOVAK
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:336-884-4001
Mailing Address - Street 1:2380 HICKSWOOD RD
Mailing Address - Street 2:
Mailing Address - City:HIGH POINT
Mailing Address - State:NC
Mailing Address - Zip Code:27265-1458
Mailing Address - Country:US
Mailing Address - Phone:336-884-4001
Mailing Address - Fax:336-884-0265
Practice Address - Street 1:2380 HICKSWOOD RD
Practice Address - Street 2:
Practice Address - City:HIGH POINT
Practice Address - State:NC
Practice Address - Zip Code:27265-1458
Practice Address - Country:US
Practice Address - Phone:336-884-4001
Practice Address - Fax:336-884-0265
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-02
Last Update Date:2010-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8996485Medicaid