Basic Information
| Provider Information | |||||||||
| NPI: | 1134352479 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | HOIKKA | ||||||||
| FirstName: | MARK | ||||||||
| MiddleName: | DAVID | ||||||||
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| Credential: | DDS | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2200 BERGQUIST DR | ||||||||
| Address2: | SUITE 1 | ||||||||
| City: | LACKLAND A F B | ||||||||
| State: | TX | ||||||||
| PostalCode: | 782369907 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2106719613 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 1615 TRUEMPER ST | ||||||||
| Address2: | |||||||||
| City: | LACKLAND A F B | ||||||||
| State: | TX | ||||||||
| PostalCode: | 782365511 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2106719613 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 09/03/2009 | ||||||||
| LastUpdateDate: | 08/24/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 08/05/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1223G0001X | 2901020081 | MI | Y | Dental Providers | Dentist | General Practice |
No ID Information.