Individual
DR. MARK D. MILLER
Active
Individual
DR. MARK D. MILLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Taxonomy
Speciality
Code
Description
License number
State
1223D0004X
Dental Anesthesiology
6861
KY
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
36087
TX
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
6861
KY
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
6861
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
60068616
—
KY
05
—
64068612
—
KY
Enumeration date
12/28/2006
Last updated
06/24/2020
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