Individual
DR. GEORGE M. MYRACLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
411 TANNER ST, SIKESTON, MO 63801-4272
(573) 471-2077
Mailing address
411 TANNER ST, SIKESTON, MO 63801-4272
(573) 471-2077
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
13502
MO
Other
Enumeration date
05/06/2008
Last updated
05/06/2008
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