Individual
DR. ALLEN RAY MIKULENCAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
4000 W MERCURY BLVD, HAMPTON, VA 23666-3700
(757) 826-7372
(757) 826-1739
Mailing address
614 MAURY AVE, NORFOLK, VA 23517-1820
(757) 627-0092
(757) 826-1739
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
0401006695
VA
Other
Enumeration date
02/02/2007
Last updated
07/08/2007
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