Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 122300000X | Dentist | 12009574 | IN |
NPI | 1013038439 |
---|---|
Provider Name | Dr. Joseph Majka |
First Address | Valparaiso, IN 46383-3707 |
Second Address | Valparaiso, IN 46383-3707 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/04/2007 |
Last Update Date | 08/07/2007 |