Individual
DR. MICHAEL JOSEPH FOMICH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
125 E MAIN ST., LOUISVILLE, OH 44641
(330) 753-3007
(330) 753-3000
Mailing address
125 E MAIN ST., LOUISVILLE, OH 44641
(330) 875-8027
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
19794
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0965988
—
OH
Enumeration date
11/27/2006
Last updated
06/27/2012
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