Organization
JACOB S MILLER, DDS, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JACOB S MILLER DDS (PRESIDENT)
(616) 901-9148
Entity
Organization
Contact information
Practice address
2730 5 MILE RD NE, SUITE #101, GRAND RAPIDS, MI 49525-6518
(616) 364-7039
(616) 364-6068
Mailing address
6689 GRAN VIA DR NE, ROCKFORD, MI 49341-9689
(616) 901-9148
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
L2901020673
MI
Other
Enumeration date
01/03/2017
Last updated
01/03/2017
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