Individual
DR. MILES LEE RENICK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
669 MONROE AVE, FORT EUSTIS, VA 23604-5005
(239) 314-8016
Mailing address
US ARMY DENTAL HEALTH ACTIVITY BAVARIA, CMR 411 UNIT 28038, APO, AE 09112
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
9654
KY
1223G0001X
General Practice Dentistry
Primary
9654
KY
Other
Enumeration date
08/03/2015
Last updated
07/10/2023
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