Individual
DR. ILLYA Y. NOVIKOV
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DOCTOR OF DENTISTRY
Contact information
Practice address
17105 SAN CARLOS BLVD, SUITE B-3, FORT MYERS BEACH, FL 33931-5336
(239) 466-2888
(239) 466-6010
Mailing address
17105 SAN CARLOS BLVD, SUITE B-3, FORT MYERS BEACH, FL 33931-5336
(239) 466-2888
(239) 466-6010
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DN15852
FL
Other
Enumeration date
04/12/2007
Last updated
07/08/2007
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