Individual
DR. ANDI MIRO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
30 E 76TH ST, NEW YORK, NY 10021-2700
(212) 794-9600
Mailing address
15 TONE LN, STATEN ISLAND, NY 10305-1649
(718) 809-0431
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
0580201
NY
Other
Enumeration date
07/28/2015
Last updated
07/28/2015
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