# MARK A. MILLER, D.D.S., PLC

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

## Provider details

- **NPI number:** 1992963805
- **Authorized official:** DR. MARK A. MILLER (OWNER)
- **Authorized official phone:** (731) 668-9898

## Contact information

- **Practice address:** 111 MURRAY GUARD DR, SUITE A, JACKSON, TN 38305-3772
- **Practice address phone:** (731) 668-9898
- **Mailing address:** 111 MURRAY GUARD DR, SUITE A, JACKSON, TN 38305-3772
- **Mailing address phone:** (731) 668-9898

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QD0000X | Dental Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 05/28/2008
- **Last updated:** 05/28/2008