Illya Novikov, DOCTOR OF DENTISTRY

NPI 1831313907 · on the registry since 2007

Practice

Address: 17105 San Carlos Blvd
Suite B-3
Fort Myers Beach, FL 33931
Phone: (239) 466-2888
Fax: (239) 466-6010
Organisation at this address: Wal-Mart Stores East Lp
Wal-Mart Stores East, Lp
Inferred from a shared address, not stated in the registry.
Clinicians at this address: 5

Registry record

Primary taxonomy: 1223G0001X
1223G0001X
Licence states on file: FL
From the registry's licence fields, which are often incomplete.
Sex: Male
Record last updated: 2007-07-08

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Florida