DR. Kenneth Lee Myracle, D.M.D.

NPI #1588862254 in Mattoon, Illinois

Provider Information

NPI Number
1588862254
Entity Type
Individual
Name
DR. Kenneth Lee Myracle, D.M.D.
Gender
Not Specified
Sole Proprietor
Yes
Primary Specialty
Dentist - General Practice
Credential
D.M.D.
Enumeration Date
Jul 4, 2007
Last Updated
Jul 8, 2007

Practice Location

Address
700 BROADWAY AVE E
ZIP Code
61938-4671
Phone
(217) 235-1101

Specialties & Taxonomy Codes

Specialty
Dentist - General PracticeGeneral Practice

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