Individual
MARK A. MILLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
133 E MAIN, CARLTON, OR 97111
(503) 852-7147
(503) 852-7149
Mailing address
PO BOX 220, CARLTON, OR 97111-0220
(503) 852-7147
(503) 852-7419
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
5513
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
075390
—
OR
Enumeration date
07/21/2005
Last updated
07/13/2026
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