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Organization
CENTER FOR ORAL AND MAXILLOFACIAL SURGERY, P.C.
Active
Organization
CENTER FOR ORAL AND MAXILLOFACIAL SURGERY, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GLENN A MILLER DDS MS (ORAL & MAXILLOFACIAL SURGEON)
(618) 387-2464
Entity
Organization
Contact information
Practice address
10200 W MAIN ST, SIGNAL HILL MEDICAL BLDG, BELLEVILLE, IL 62223-1408
(618) 397-2464
(618) 398-4450
Mailing address
10200 WEST MAIN, SIGNAL HILL MEDICAL BLDG, BELLEVILLE, IL 62223
(618) 397-2464
(618) 398-4450
Taxonomy
Speciality
Code
Description
License number
State
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
Primary
060000298
IL
Other
Enumeration date
05/10/2007
Last updated
06/03/2011
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