Individual
EDWARD MCMILLAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
224 WEST D. L. INGRAM AVE, BLDG 1408, CANNON AFB, NM 88103-5014
(575) 784-2778
Mailing address
77 NEALY AVE, LANGLEY AFB, VA 23665-2040
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
10823
SC
390200000X
Student in an Organized Health Care Education/Training Program
DGD.10823
SC
Other
Enumeration date
04/22/2024
Last updated
08/28/2025
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