| Miracle Lane Family Dentistry P.c. | |
|
2332 Miracle Ln Mishawaka IN 46545-3012 | |
| (574) 259-5437 | |
| (574) 259-5438 |
| Full Name | Miracle Lane Family Dentistry P.c. |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 2332 Miracle Ln, Mishawaka, Indiana |
| Authorized Official Name and Position | Bridget Lynn Merritt-brooks (DENTIST/OWNER) |
| Authorized Official Contact | 3136104688 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Miracle Lane Family Dentistry P.c. 2332 Miracle Ln Mishawaka IN 46545-3012 Ph: (574) 259-5437 | Miracle Lane Family Dentistry P.c. 2332 Miracle Ln Mishawaka IN 46545-3012 Ph: (574) 259-5437 |
| NPI Number | 1093122418 |
|---|---|
| Provider Enumeration Date | 07/17/2014 |
| Last Update Date | 07/17/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1093122418 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | 54001789A (Indiana) | Primary |
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