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Individual
DR. JUSTIN CHARLES MIRANDE
Active
Individual
DR. JUSTIN CHARLES MIRANDE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
D008719
AZ
122300000X
Dentist
Primary
DDS107398
CA
1223G0001X
General Practice Dentistry
019030118
IL
1223G0001X
General Practice Dentistry
9920
TN
Other
Enumeration date
05/30/2013
Last updated
08/21/2023
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