Individual
DR. JACK OLEN MILLS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
60 FENTON ST, SUITE 7, LIVERMORE, CA 94550-4148
(925) 443-4211
(925) 443-4716
Mailing address
60 FENTON ST, SUITE 7, LIVERMORE, CA 94550-4148
(925) 443-4211
(925) 443-4716
Taxonomy
Speciality
Code
Description
License number
State
1223P0106X
Oral and Maxillofacial Pathology Dentistry
Primary
16954
CA
Other
Enumeration date
12/28/2006
Last updated
07/08/2007
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