# JACOB S MILLER, DDS, PLLC

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

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

## Provider details

- **NPI number:** 1689119414
- **Authorized official:** DR. JACOB S MILLER DDS (PRESIDENT)
- **Authorized official phone:** (616) 901-9148

## Contact information

- **Practice address:** 2730 5 MILE RD NE, SUITE \#101, GRAND RAPIDS, MI 49525-6518
- **Practice address phone:** (616) 364-7039
- **Practice address fax:** (616) 364-6068
- **Mailing address:** 6689 GRAN VIA DR NE, ROCKFORD, MI 49341-9689
- **Mailing address phone:** (616) 901-9148

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | L2901020673 | MI | Yes |

## Other

- **Enumeration date:** 01/03/2017
- **Last updated:** 01/03/2017