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Individual

DR. ROBERT MIRACLE

Active
Sole proprietor

Provider details

NPI number
Gender
Man
Credential
DMD

Contact information

Practice address
1810 NW FERRIS AVE, LAWTON, OK 73507-5625
(580) 355-1314
(580) 355-1027
Mailing address
1810 NW FERRIS AVE, LAWTON, OK 73507-5625
(580) 355-1314
(580) 355-1027

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
5347
OK

Other

Enumeration date
10/10/2005
Last updated
07/09/2007
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