Organization
MIRACLE DENTAL CENTER PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JERRY E MIRACLE (DENTIST)
(704) 289-1993
Entity
Organization
Contact information
Practice address
1329 PATTERSON ST, MONROE, NC 28112-4349
(704) 289-1993
(704) 226-1743
Mailing address
1329 PATTERSON ST, MONROE, NC 28112-4349
(704) 289-1993
(704) 226-1743
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
7308
NC
Other
Enumeration date
03/06/2007
Last updated
08/22/2020
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