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1053635615
ROBERT L MIRACLE, DMD, PC
LAWTON, OK
NPI
1053635615
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Entity Type
Organization
Authorized Contact
ROBERT MIRACLE
President
580-355-1314
Organization Subpart ?
No
Primary Taxonomy
261QD0000X Clinic/Center, Dental
(Licence: OK 4 5347)
Enumeration Date
2010-03-25
Last Update Date
2010-03-25
Business Address
ROBERT L MIRACLE, DMD, PC
1810 NW FERRIS AVE
LAWTON, OK 73507-5625
Phone number: 580-355-1314
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Mailing Address
ROBERT L MIRACLE, DMD, PC
1810 NW FERRIS AVE
LAWTON, OK 73507-5625
Phone number: 580-355-1314
Copy
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