Organization
MYRACLE ORTHODONTICS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GEORGE M. MYRACLE D.D.S. (ORTHODONTIST)
(812) 858-0711
Entity
Organization
Contact information
Practice address
8900 RUFFIAN LN, NEWBURGH, IN 47630-3424
(812) 858-0711
Mailing address
8900 RUFFIAN LN, NEWBURGH, IN 47630-3424
(812) 858-0711
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
12010421A
IN
Other
Enumeration date
05/06/2008
Last updated
05/06/2008
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