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Organization
PREMIER FAMILY DENTAL
Active
Organization
PREMIER FAMILY DENTAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TODD MILLER DMD (DENTIST)
(815) 468-3020
Entity
Organization
Contact information
Practice address
190 MARQUETTE PL S, MANTENO, IL 60950-3721
(815) 468-3020
Mailing address
1922 EDWARDSVILLE CLUB PLAZA CT, EDWARDSVILLE, IL 62025-3717
(815) 474-7655
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
09/04/2025
Last updated
09/04/2025
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