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Contact Information

CHARLES BUKOVAC, DMD
215 SOUTH STURGEON ST
MONTGOMERY CITY, MO63361
 Phone: 573-564-3726
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

General Practice

1223G0001X
Indicates primary specialty

NPI Profile & details for CHARLES BUKOVAC · (Male)

NPI # 1508101338
Status Active
Credentials DMD (Doctor of Medical Dentistry)
Entity Individual
Enumeration date 12/05/2012
Last updated 12/05/2012 - About 14 years ago
Sole proprietor 1 No
Identifiers
  • MO License # 2012029542
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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