Individual
DR. DIEGO E MIRON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
7 SOUTHWOODS BLVD, ALBANY, NY 12211-2526
(518) 445-2505
(518) 445-2508
Mailing address
7 SOUTHWOODS BLVD, ALBANY, NY 12211-2526
(518) 445-2505
(518) 445-2508
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
052080-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02703166
—
NY
01
—
10115921
CDPHP
NY
Enumeration date
11/28/2006
Last updated
08/20/2007
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