Individual
DR. JASMINE RENEE MIRANDA LOPEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
223 S PLEASANT AVE STE 303, SOMERSET, PA 15501-2188
(814) 445-4636
Mailing address
837 E MAIN ST APT 6, SOMERSET, PA 15501-2180
(732) 208-9624
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DS044355
PA
Other
Enumeration date
09/11/2023
Last updated
09/11/2023
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