Provider Demographics
NPI:1083361729
Name:MINKA HOTIC, DDS, PLLC
Entity Type:Organization
Organization Name:MINKA HOTIC, DDS, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:MINKA
Authorized Official - Middle Name:
Authorized Official - Last Name:HOTIC
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:239-410-9634
Mailing Address - Street 1:1116 HEARTHSTONE CT
Mailing Address - Street 2:
Mailing Address - City:ROCK HILL
Mailing Address - State:SC
Mailing Address - Zip Code:29732-9494
Mailing Address - Country:US
Mailing Address - Phone:239-410-9634
Mailing Address - Fax:
Practice Address - Street 1:112 S TRYON ST STE 650
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28284-2102
Practice Address - Country:US
Practice Address - Phone:704-375-0500
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-03-02
Last Update Date:2022-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty