Provider Demographics
NPI:1770570939
Name:MIHALIK, COLIN ANTONY (DDS)
Entity type:Individual
Prefix:
First Name:COLIN
Middle Name:ANTONY
Last Name:MIHALIK
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:5525 S STAPLES ST
Mailing Address - Street 2:BLDG. C
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78411-5357
Mailing Address - Country:US
Mailing Address - Phone:361-992-4746
Mailing Address - Fax:361-992-8095
Practice Address - Street 1:5525 S STAPLES ST
Practice Address - Street 2:BLDG. C
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78411-5357
Practice Address - Country:US
Practice Address - Phone:361-992-4746
Practice Address - Fax:361-992-8095
Is Sole Proprietor?:No
Enumeration Date:2005-10-04
Last Update Date:2018-06-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TX176361223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics