# MARK D, MILLERDDSPSC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1184892010
- **Authorized official:** DR. MARK DELMAR MILLER DDS (PRESIDENT)
- **Authorized official phone:** (270) 885-0165

## Contact information

- **Practice address:** 320 COOL WATER CT, HOPKINSVILLE, KY 42240-8738
- **Practice address phone:** (270) 885-0165
- **Practice address fax:** (270) 886-2224
- **Mailing address:** 320 COOL WATER CT, HOPKINSVILLE, KY 42240-8738
- **Mailing address phone:** (270) 885-0165
- **Mailing address fax:** (270) 886-2224

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | — | NULL | Yes |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | — | — | Yes |

## Other

- **Enumeration date:** 02/13/2008
- **Last updated:** 04/02/2008