Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 122300000X | Dentist | 2901016164 | MI |
N | 122300000X | Dentist | 7186 | WI |
N | 1223D0001X | Dental Public Health | 30.024848 | OH |
NPI | 1245493048 |
---|---|
Provider Name | Dr. Tommy R Onjukka |
First Address | Dayton, OH 45402-1367 |
Second Address | Dayton, OH 45402-1367 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/07/2008 |
Last Update Date | 13/04/2017 |