Individual
MR. JERRY SIDNEY MILLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
1110 TIBBITS DRIVE, OGDENSBURG, NY 13669
(315) 393-8400
(315) 393-0167
Mailing address
9298 STATE HIGHWAY 37, OGDENSBURG, NY 13669-3486
(315) 393-3143
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
043376-1
NY
Other
Enumeration date
08/26/2021
Last updated
08/26/2021
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