Individual
DR. JERRY A MILES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
26317 W WASHINGTON STREET, BUILDING 110, PETERSBURG, VA 23803
(804) 524-7257
(804) 524-6496
Mailing address
26317 W WASHINGTON STREET, P.O. BOX 4030, PETERSBURG, VA 23803-2727
(804) 524-7257
(804) 524-6496
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
0401005996
VA
Other
Enumeration date
11/29/2006
Last updated
01/11/2019
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