Individual
MIRA EGBARIA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.D.S.
Contact information
Practice address
201 E HURON ST, GALTER 2-246, CHICAGO, IL 60611-3197
(256) 503-5241
Mailing address
2736 MUIR WOODS DR SE, OWENS CROSS ROADS, AL 35763-8615
(256) 503-5241
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
04/18/2016
Last updated
04/18/2016
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