Provider Demographics
NPI:1346658127
Name:JOSEPH J MIRCI DMD
Entity type:Organization
Organization Name:JOSEPH J MIRCI DMD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:J
Authorized Official - Last Name:MIRCI
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:907-283-9125
Mailing Address - Street 1:47707 JUDY LYNN LANE
Mailing Address - Street 2:
Mailing Address - City:SOLDOTNA
Mailing Address - State:AK
Mailing Address - Zip Code:99669
Mailing Address - Country:US
Mailing Address - Phone:907-283-9125
Mailing Address - Fax:907-531-8004
Practice Address - Street 1:47707 JUDY LYNN LANE
Practice Address - Street 2:
Practice Address - City:SOLDOTNA
Practice Address - State:AK
Practice Address - Zip Code:99669
Practice Address - Country:US
Practice Address - Phone:907-283-9125
Practice Address - Fax:907-531-8004
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-07-24
Last Update Date:2024-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty
No1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty