Individual
BRIAN KEITH MILLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Contact information
Practice address
420 DOUGLAS AVE, BREWTON, AL 36426-2052
(251) 867-5625
(251) 867-5648
Mailing address
420 DOUGLAS AVE, BREWTON, AL 36426-2052
(251) 867-5625
(251) 867-5648
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
4452
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
90978
BLUE CROSS & BLUE SHIELD
AL
Enumeration date
01/19/2007
Last updated
07/08/2007
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