JERRY ERVIN MIRACLE

MONROE, NC
NPI1306908165
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy1223G0001X Dentist, General Practice
(Licence: NC  7308)
Enumeration Date2006-12-15
Last Update Date2007-07-08
Business Address
Dr. JERRY ERVIN MIRACLE DDS
1329 PATTERSON ST
MONROE, NC 28112-4349
Phone number: 704-289-1993
Mailing Address
Dr. JERRY ERVIN MIRACLE DDS
1329 PATTERSON ST PO BOX 949
MONROE, NC 28112-4349
Phone number: 704-289-1993
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