Individual
CORDIN MIRISE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
850 CEDAR LN, FRANKLIN, IN 46131-1089
(173) 737-7476
Mailing address
3325 W 100 N, BARGERSVILLE, IN 46106-9582
(317) 670-7079
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
12014404A
IN
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/01/2024
Last updated
05/27/2024
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