| Mir Dental Inc. | |
|
800 Jessup Rd Suite 805 Thorofare NJ 08086-9354 | |
| (856) 845-4390 | |
| (856) 845-5342 |
| Full Name | Mir Dental Inc. |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 800 Jessup Rd, Thorofare, New Jersey |
| Authorized Official Name and Position | Michael Irwin Rouff (OWNER) |
| Authorized Official Contact | 8568454390 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Mir Dental Inc. 800 Jessup Rd Suite 805 Thorofare NJ 08086-9354 Ph: (856) 845-4390 | Mir Dental Inc. 800 Jessup Rd Suite 805 Thorofare NJ 08086-9354 Ph: (856) 845-4390 |
| NPI Number | 1114072246 |
|---|---|
| Provider Enumeration Date | 01/25/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1114072246 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | 22DI01654300 (New Jersey) | Primary |