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Individual

DR. MARK A. MIKUS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
D.M.D.

Contact information

Practice address
9400 MCKNIGHT RD STE 101, PITTSBURGH, PA 15237-6007
(412) 369-7122
(412) 369-7433
Mailing address
505 CREEKSIDE CT, CRANBERRY TOWNSHIP, PA 16066-3371
(724) 772-3209
(412) 369-7433

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DS031540L
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1021208600001
PA
Enumeration date
10/24/2005
Last updated
05/21/2008
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