Individual
JOSEPH A MIKA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS,LLC
Contact information
Practice address
5815 MARKET ST STE 6, BOARDMAN, OH 44512-2915
(330) 758-2156
(330) 758-7274
Mailing address
5815 MARKET ST STE 6, BOARDMAN, OH 44512-2915
(330) 758-2156
(330) 758-7274
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
30-01-9439
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0916594
—
OH
01
—
30-01-9439
OHIO DENTIST LICENSE
OH
Enumeration date
11/08/2005
Last updated
10/18/2010
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