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Individual

STEPHEN J HOLKA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
100 N. BROADWAY STREET, OAKTOWN, IN 47561-0269
(812) 745-4151
Mailing address
100 N. BROADWAY STREET, PO BOX 269, OAKTOWN, IN 47561-0269
(812) 745-4151

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
12010551A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
200357310A
IN
05
200435290
IN
Enumeration date
11/10/2006
Last updated
04/06/2015
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