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Individual

DR. TIMOTHY STEPHEN NOVAK

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.D.S.

Contact information

Practice address
1111 DELAFIELD ST, SUITE 222, WAUKESHA, WI 53188-3417
(262) 547-8665
(262) 547-4328
Mailing address
1111 DELAFIELD ST, SUITE 222, WAUKESHA, WI 53188-3417
(262) 547-8665
(262) 547-4328

Taxonomy

Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
4362
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1008606
PHYSICIANS PLUS
WI
01
10571
DEANCARE HMO
WI
01
2011072002
CIGNA MEDICAL
WI
05
33709900
WI
01
759310
UNITED CONCORDIA DENTAL
WI
Enumeration date
08/25/2006
Last updated
07/08/2007
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