Individual
MITRA MIA ASTAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
26 PONDFIELD RD WEST, BRONXVILLE, NY 10708
(914) 779-7711
Mailing address
229 OSBORN RD, HARRISON, NY 10528
(914) 921-9080
Taxonomy
Speciality
Code
Description
License number
State
1223P0300X
Periodontics
Primary
0420581
NY
Other
Enumeration date
03/12/2007
Last updated
07/08/2007
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