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Organization
ROGER K MILLER DDS PA
Active
Organization
ROGER K MILLER DDS PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROGER K MILLER DDS PA (DR)
(704) 739-7956
Entity
Organization
Contact information
Practice address
1303 PLAZA DR, KINGS MOUNTAIN, NC 28086-2653
(704) 739-7956
Mailing address
P.O. BOX 638, KINGS MTN, NC 28086-0638
(704) 739-7956
(704) 739-1659
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
NC5035
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7995963
—
NC
01
—
95963
BC & BS
NC
Enumeration date
02/13/2008
Last updated
07/16/2008
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