Individual
MIRIAM CAROLINE OMALLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DMD
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
027676L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01696297
—
PA
Enumeration date
10/10/2006
Last updated
10/10/2013
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