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1124184056
MALCOLM BAKER MIRACLE
FLORENCE, KY
NPI
1124184056
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
1223G0001X Dentist General Practice
(Licence: KY 6261)
Enumeration Date
2006-12-28
Last Update Date
2020-05-04
Business Address
DR. MALCOLM BAKER MIRACLE D.M.D.
7607 DIXIE HWY
FLORENCE, KY 41042-2644
Phone number: 859-655-6100
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Mailing Address
DR. MALCOLM BAKER MIRACLE D.M.D.
1401 MADISON AVE
COVINGTON, KY 41011-3313
Phone number: 859-655-6100
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