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Individual

JEFFREY T MILNE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.D.S.

Contact information

Practice address
548 RIDGE ROAD SUITE A, MUNSTER, IN 46321-1722
(219) 836-9122
(219) 836-9123
Mailing address
548 RIDGE ROAD SUITE A, MUNSTER, IN 46321-1722
(219) 836-9122
(219) 836-9123

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
12010293A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
12010293A
LICENSE NUMBER
IN
Enumeration date
11/01/2006
Last updated
07/09/2007
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