Individual
MRS. MIRANDA ANN CARLILE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RDH
Contact information
Practice address
1105 MEMORIAL DR, ARTESIA, NM 88210-1189
(575) 746-9848
Mailing address
PO BOX 2267, SANTA FE, NM 87504-2267
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
DH3530
NM
Other
Enumeration date
10/25/2011
Last updated
11/06/2017
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