Individual
DR. KENNETH BRYCE MILLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
2809 W 95TH, EVERGREEN PARK, IL 60805
(708) 425-3336
Mailing address
2809 W 95TH, EVERGREEN PARK, IL 60805
(708) 425-3336
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
019.015505
IL
Other
Enumeration date
09/09/2008
Last updated
09/09/2008
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