Individual
DR. SAMUEL PAUL MIANO JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S., L.L.C.
Contact information
Practice address
674 CENTRAL AVE, RESERVE, LA 70084-5514
(985) 536-3455
(985) 536-8865
Mailing address
674 CENTRAL AVE, RESERVE, LA 70084-5514
(985) 536-3455
(985) 536-8865
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
4090
LA
Other
Enumeration date
03/06/2007
Last updated
11/01/2009
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