Individual
WILLIE L MILLER
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
D.D.S., P.A.
Contact information
Practice address
9110 GARNERS FERRY RD, HOPKINS, SC 29061-9561
(803) 783-2686
(803) 783-7519
Mailing address
9110 GARNERS FERRY RD, HOPKINS, SC 29061-9561
(803) 783-2686
(803) 783-7519
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
2341
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
591842
TRICARE
SC
05
—
Z23412
—
SC
05
—
ZA9966
—
SC
Enumeration date
05/16/2006
Last updated
07/08/2007
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