Basic Information
| Provider Information | |||||||||
| NPI: | 1255481206 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | STYKA | ||||||||
| FirstName: | DOUGLAS | ||||||||
| MiddleName: | JAMES | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | D.D.S. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3768 BOARDMAN CANFIELD RD | ||||||||
| Address2: | |||||||||
| City: | CANFIELD | ||||||||
| State: | OH | ||||||||
| PostalCode: | 444068502 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3307021288 | ||||||||
| FaxNumber: | 3307021291 | ||||||||
| Practice Location | |||||||||
| Address1: | 3768 BOARDMAN CANFIELD RD | ||||||||
| Address2: | |||||||||
| City: | CANFIELD | ||||||||
| State: | OH | ||||||||
| PostalCode: | 444068502 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3307021288 | ||||||||
| FaxNumber: | 3307021291 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/11/2007 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1223G0001X | 30.020033 | OH | Y | Dental Providers | Dentist | General Practice |
No ID Information.