# JARED MILLER DDS PLLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Gantry Oral & Maxillofacial Surgery
- **Organization subpart:** No

## Provider details

- **NPI number:** 1699593541
- **Authorized official:** JARED MILLER DDS (OWNER)
- **Authorized official phone:** (929) 344-5310

## Contact information

- **Practice address:** 548 50TH AVE, LONG ISLAND CITY, NY 11101-5712
- **Practice address phone:** (929) 344-5310
- **Mailing address:** 548 50TH AVE, LONG ISLAND CITY, NY 11101-5712
- **Mailing address phone:** (929) 344-5310
- **Mailing address fax:** (929) 344-5308

## 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:** 09/30/2024
- **Last updated:** 09/30/2024