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Individual
DR. RANDALL W MIKULIK
Active
Individual
DR. RANDALL W MIKULIK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Taxonomy
Speciality
Code
Description
License number
State
1223E0200X
Endodontics
DT-2054
HI
1223G0001X
General Practice Dentistry
Primary
19915
TX
1223G0001X
General Practice Dentistry
DT-2054
HI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00992101
—
HI
01
—
2054
HAWAII DENTAL SERVICE
HI
01
—
241943
HMSA
HI
Enumeration date
10/25/2006
Last updated
05/12/2022
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