Individual
DR. JONATHAN DANIEL MILLS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
4050 BEYER BLVD, SAN YSIDRO, CA 92173-2007
(619) 662-4100
Mailing address
PO BOX 3414, SAN DIEGO, CA 92163-1414
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
110142
CA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/19/2022
Last updated
07/18/2024
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