Individual
DR. GARY H MIKELS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
348 NORTH PEARL ST, SUITE 1, BROCKTON, MA 02301
(508) 584-6070
(508) 275-3935
Mailing address
348 NORTH PEARL ST, SUITE 1, BROCKTON, MA 02301
(508) 584-6070
(508) 275-3935
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
13897
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0251992
—
MA
Enumeration date
07/16/2006
Last updated
07/08/2007
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