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Individual

DR. JEFF MCMILLIN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
D.D.S.

Contact information

Practice address
1705 EDGEMON AVENUE, BRISTOL, TN 37620
(423) 968-1933
(423) 968-5015
Mailing address
120 PHLOX CRK, BRISTOL, TN 37620-4757
(423) 968-1933

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DS3753
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
AM1093525
D.E.A.
TN
Enumeration date
11/16/2006
Last updated
07/08/2007
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