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Individual

DR. MIRA YI

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
DDS

Contact information

Practice address
321 BROAD AVE, BUILDING F #5, RIDGEFIELD, NJ 07657-2346
(201) 313-2277
(201) 313-0377
Mailing address
321 BROAD AVE, BUILDING F #5, RIDGEFIELD, NJ 07657-2346
(201) 313-2277
(201) 313-0377

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
22DJ02249800
NJ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
02495687
NY
Enumeration date
12/14/2009
Last updated
12/14/2009
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