Organization
DAVID E MIRANDA DDS INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DAVID E MIRANDA DDS (PRESIDENT)
(304) 522-0395
Entity
Organization
Contact information
Practice address
1225 WASHINGTON AVE, HUNTINGTON, WV 25704
(304) 522-0395
(304) 523-0903
Mailing address
1225 WASHINGTON AVE, HUNTINGTON, WV 25704
(304) 522-0395
(304) 523-0903
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
3097
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0133749000
—
WV
Enumeration date
08/12/2006
Last updated
08/22/2020
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