Provider Demographics
NPI:1386865285
Name:MIHALKO, ANN M (DMD)
Entity Type:Individual
Prefix:MRS
First Name:ANN
Middle Name:M
Last Name:MIHALKO
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9192 BRENDAN PRESERVE CT
Mailing Address - Street 2:
Mailing Address - City:BONITA SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:34135-4376
Mailing Address - Country:US
Mailing Address - Phone:941-266-2096
Mailing Address - Fax:
Practice Address - Street 1:25000 BERNWOOD DR
Practice Address - Street 2:
Practice Address - City:BONITA SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:34135-7900
Practice Address - Country:US
Practice Address - Phone:239-948-6565
Practice Address - Fax:239-948-6566
Is Sole Proprietor?:No
Enumeration Date:2007-05-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN169991223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice