Individual
CHARLES B MILLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
200 S ERIE ST, MERCER, PA 16137
(724) 622-3833
(724) 662-1308
Mailing address
200 S ERIE ST, MERCER, PA 16137
(724) 622-3833
(724) 662-1308
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DS020421 L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0005194020001
—
PA
01
—
039953
UNITED CONCORDIA
PA
Enumeration date
08/18/2006
Last updated
07/08/2007
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