Individual
DR. MARK T. MILLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
307 N 300 W STE 304, KAYSVILLE, UT 84037-1852
(801) 544-4003
Mailing address
307 N 300 W STE 304, KAYSVILLE, UT 84037-1852
(801) 544-4003
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
99-375792-9921
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
870623840-00001
DELTA DENTAL
MN
Enumeration date
10/09/2008
Last updated
10/03/2012
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