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Individual

DR. JOHN ROBERT MILLER

Active
Sole proprietor

Provider details

NPI number
Gender
Man
Credential
DDS

Contact information

Practice address
370 3RD AVE S, ISLE, MN 56342
(320) 676-3232
(320) 676-8460
Mailing address
PO BOX 1, ISLE, MN 56342-0001
(320) 676-3232
(320) 676-8460

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D9332
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
D9332
PROVIDER LICENSE NUMBER
MN
Enumeration date
06/22/2005
Last updated
07/08/2007
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