Individual
RYAN MIRCHEL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S., M.D.
Contact information
Practice address
539 W COMMERCE ST STE 5577, DALLAS, TX 75208-1953
(469) 278-4323
Mailing address
539 W COMMERCE ST STE 5577, DALLAS, TX 75208-1953
(469) 278-4323
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
25908
TX
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
D010221
AZ
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
30 024690
OH
Other
Enumeration date
05/06/2010
Last updated
01/22/2022
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