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Individual

DR. PHILIP CARLTON MILLS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DMD

Contact information

Practice address
13255 SE STARK ST, PORTLAND, OR 97233-1548
(503) 255-1901
(503) 255-3114
Mailing address
6950 NE CAMPUS WAY, HILLSBORO, OR 97124-5611
(503) 952-2000
(503) 255-3114

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
DE 60121517
WA
1223G0001X
General Practice Dentistry
Primary
D5838
OR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
228965
OREGON HEALTH PLAN PROVID
OR
Enumeration date
09/26/2006
Last updated
04/30/2015
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