Organization
MILLER ENDODONTIC ADVANTAGE, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARCUS MILLER DDS (OWNER DOCTOR)
(651) 431-1045
Entity
Organization
Contact information
Practice address
11601 MINNETONKA MILLS RD STE C10, MINNETONKA, MN 55305-5170
(952) 938-3033
Mailing address
1515 ARGONNE LN, ALPHARETTA, GA 30004-7884
(651) 431-1045
Taxonomy
Speciality
Code
Description
License number
State
1223E0200X
Endodontics
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
OPTIONAL
OPTIONAL
—
Enumeration date
03/14/2022
Last updated
03/14/2022
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