Individual
LAUREL MIRA SHIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
2702 S BUCKNER BLVD STE 120, DALLAS, TX 75227-6700
(469) 399-6664
Mailing address
6050 N CENTRAL EXPY APT 1410, DALLAS, TX 75206-5395
(702) 904-0480
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
36839
TX
Other
Enumeration date
08/04/2017
Last updated
03/07/2023
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