Individual
GREGORY LEE MILLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
3405 DERR PARK RD SE, SALEM, OR 97310-0001
(503) 373-0891
(503) 378-8628
Mailing address
1170 13TH ST NE, SALEM, OR 97301-1309
(503) 798-1579
(503) 378-8628
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D4753
OR
Other
Enumeration date
07/25/2018
Last updated
07/25/2018
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