Individual
DR. EDWARD RAY MILLER JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
4121 ELM PARK DR, SAINT LOUIS, MO 63128
(314) 845-2730
Mailing address
3700 N BELT W, BELLEVILLE, IL 62226-5629
(618) 233-3701
(618) 233-6721
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
19-026162
IL
1223G0001X
General Practice Dentistry
Primary
2018014802
MO
Other
Enumeration date
07/25/2006
Last updated
07/18/2018
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