Individual
REBECCA GWENDOLYN MILLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
6145 DESERT STORM AVE, FORT CAMPBELL, KY 42223-5558
(270) 412-2787
Mailing address
874 NEEDMORE RD APT P4, CLARKSVILLE, TN 37040-2346
(540) 931-8453
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
11133
KY
Other
Enumeration date
08/06/2024
Last updated
08/06/2024
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