NPI | 1821610395 |
---|---|
Doing Business As | MIRAGE DENTAL ARTS |
Entity Type | Organization |
Authorized Contact | KATHERINE LORENZO SIRAGE Owner 786-223-9795 |
Organization Subpart ? | No |
Primary Taxonomy | 1223G0001X Dentist, General Practice |
Enumeration Date | 2020-05-07 |
Last Update Date | 2020-10-13 |