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Individual

DR. GARY LYNN MILLER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
D.D.S.

Contact information

Practice address
806 N MAIN ST, JENNINGS, LA 70546-4728
(337) 824-2422
(337) 824-0047
Mailing address
806 N MAIN ST, JENNINGS, LA 70546-4728
(337) 824-2422
(337) 824-0047

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
3439
LA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1834394
LA
01
G4862
BLUE CROSS BLUE SHIELD
LA
Enumeration date
03/23/2006
Last updated
05/19/2014
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