# NOVA DENTAL INCORPORATED

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1891121422
- **Authorized official:** SUO JI DMD (PRESIDENT)
- **Authorized official phone:** (520) 325-1098

## Contact information

- **Practice address:** 4411 E 5TH ST, SUITE D, TUCSON, AZ 85711-2015
- **Practice address phone:** (520) 325-1098
- **Practice address fax:** (520) 325-1112
- **Mailing address:** 4411 E 5TH ST, SUITE D, TUCSON, AZ 85711-2015
- **Mailing address phone:** (520) 325-1098
- **Mailing address fax:** (520) 325-1112

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | D6339 | AZ | Yes |

## Other

- **Enumeration date:** 09/14/2013
- **Last updated:** 09/14/2013