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Organization
MIRACLE LANE FAMILY DENTISTRY P.C.
Active
Organization
MIRACLE LANE FAMILY DENTISTRY P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BRIDGET LYNN MERRITT-BROOKS D.D.S. (DENTIST/OWNER)
(313) 610-4688
Entity
Organization
Contact information
Practice address
2332 MIRACLE LN, MISHAWAKA, IN 46545-3012
(574) 259-5437
(574) 259-5438
Mailing address
2332 MIRACLE LN, MISHAWAKA, IN 46545-3012
(574) 259-5437
(574) 259-5438
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
54001789A
IN
Other
Enumeration date
07/17/2014
Last updated
07/17/2014
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