Individual
OCTAVIA MILLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
8956 J M KEYNES DR STE 500, CHARLOTTE, NC 28262-8626
(980) 890-7590
Mailing address
200 FOSBURY WAY APT A, GREENVILLE, NC 27834-0211
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
13234
NC
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
08/01/2022
Last updated
07/26/2023
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