Individual
RACHEL JULIA MIRO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1991 N WILLIAMSBURG DR, DECATUR, GA 30033-3500
(404) 321-4588
Mailing address
1991 N WILLIAMSBURG DR, DECATUR, GA 30033-3500
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
DN016158-T
GA
1223G0001X
General Practice Dentistry
Primary
DN016158
GA
390200000X
Student in an Organized Health Care Education/Training Program
DN25496
FL
Other
Enumeration date
02/27/2020
Last updated
08/11/2021
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