Healthcare Provider Details
I. General information
NPI: 1942609367
Provider Name (Legal Business Name): MIRCEA DANIEL CHIRLA D.D.S.
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 08/21/2014
Last Update Date: 10/01/2019
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2156 SPRING STUEBNER RD
SPRING TX
77389-4813
US
IV. Provider business mailing address
2536 AMHERST ST STE A
HOUSTON TX
77005-3207
US
V. Phone/Fax
- Phone: 713-587-9996
- Fax:
- Phone: 713-490-8880
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 122300000X |
| Taxonomy | Dentist |
| License Number | 30314 |
| License Number State | TX |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: