Organization
NEW IMAGE DENTISTRY, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MIRIAM NOSRATI DDS (DENTIST)
(405) 285-8880
Entity
Organization
Contact information
Practice address
1900 E 15TH ST STE 700A, EDMOND, OK 73013-6692
(405) 285-8880
(405) 285-8881
Mailing address
1900 E 15TH ST STE 700A, EDMOND, OK 73013-6692
(405) 285-8880
(405) 285-8881
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
5705
OK
Other
Enumeration date
02/12/2008
Last updated
02/12/2008
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