Most Relevant Information
Provider Data
| NPI Number: | 1003382490 |
| Provider Name: | MIREYA E IMITOLA ORTA |
| Entity Type: | Individual |
| Taxonomy Code: | 1223P0700X |
| Specialty: | Dentist |
| License Number: | 34534 |
Most Important Dates
| Enumeration Date: | 10/23/2018 |
| Last Updated: | 10/23/2018 |
Provider Practice Location
2305 CEDAR SPRINGS RD
DALLAS
TX
752011854
Practice Location Phone/Fax
| Phone: | 2149691000 |
| Fax: |
Provider Mailing Location
2820 GOLDEN MEADOW AVE
MESQUITE
TX
751812147
Provider Mailing Phone/Fax
| Phone: | 9723101172 |
| Fax: |