# ROGER K MILLER DDS PA

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

## Provider details

- **NPI number:** 1649448549
- **Authorized official:** ROGER K MILLER DDS PA (DR)
- **Authorized official phone:** (704) 739-7956

## Contact information

- **Practice address:** 1303 PLAZA DR, KINGS MOUNTAIN, NC 28086-2653
- **Practice address phone:** (704) 739-7956
- **Mailing address:** P.O. BOX 638, KINGS MTN, NC 28086-0638
- **Mailing address phone:** (704) 739-7956
- **Mailing address fax:** (704) 739-1659

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | NC5035 | NC | Yes |

## Other

- **Enumeration date:** 02/13/2008
- **Last updated:** 07/16/2008

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 7995963 | — | NC |
| 01 | — | 95963 | BC & BS | NC |