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General NPI Number Information
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NPI Number | 1720965585
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Entity Type | Individual
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Provider Name | MYKOLA STETSKIV DMD
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Gender | Male
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Dates
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Enumeration Date | 08/21/2025
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Last Update Date | 08/21/2025
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Provider Practice Location Address
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Address Line | 3684A DRESSLER RD NW
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City | CANTON
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State | OH
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Zip | 44718-2781
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Country | US
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Telephone | 330-452-2255
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Fax |
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Provider Business Mailing Address
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Address Line | 6228 S PARK BLVD
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City | PARMA
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State | OH
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Zip | 44134-3938
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Country | US
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Telephone | 440-840-6170
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 30.028191
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License Number State | OH
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