Provider Demographics
NPI:1174945448
Name:KOVAL, CHRISTINE (DMD)
Entity type:Individual
Prefix:DR
First Name:CHRISTINE
Middle Name:
Last Name:KOVAL
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2477 STICKNEY POINT RD
Mailing Address - Street 2:SUITE 216A
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34231
Mailing Address - Country:US
Mailing Address - Phone:941-923-5406
Mailing Address - Fax:941-923-0741
Practice Address - Street 1:2477 STICKNEY POINT RD
Practice Address - Street 2:SUITE 216A
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34231-4076
Practice Address - Country:US
Practice Address - Phone:941-923-5406
Practice Address - Fax:941-923-0741
Is Sole Proprietor?:Yes
Enumeration Date:2014-01-06
Last Update Date:2014-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN9651122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL1316199425OtherNPI