Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223D0001X | Dental Public Health | DI16158 | NJ |
NPI | 1477021202 |
---|---|
Provider Name | Dr. Joseph D. Miranda |
First Address | Whippany, NJ 07981-1941 |
Second Address | Whippany, NJ 07981-1941 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 09/11/2018 |
Last Update Date | 09/11/2018 |