Individual
KENNETH LEE MILLS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
244 NE DIVISION, MYRTLE CREEK, OR 97457
(541) 863-5246
Mailing address
PO BOX 5008, MYRTLE CREEK, OR 97457
(541) 863-5246
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D4754
OR
Other
Enumeration date
10/25/2006
Last updated
07/08/2007
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