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Individual

DR. MICHAEL J MISENCIK

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DDS

Contact information

Practice address
109 HARRIS ROAD, LODI, OH 44254
(330) 302-4005
Mailing address
1205 CANYON VIEW RD, SAGAMORE HILLS, OH 44067
(216) 688-6349

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
018257
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0666097
OH
Enumeration date
03/25/2009
Last updated
06/30/2023
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