Organization
BRIAN H. MILLER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NANCY KOUMANTZELIS (SECRETARY)
16179640073
Entity
Organization
Contact information
Practice address
23 PLEASANT ST, NEWTON CENTRE, MA 02459-1836
(161) 796-4007
Mailing address
23 LOCKE RD, WABAN, MA 02468-1415
(167) 196-9277
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
—
—
Other
Enumeration date
06/15/2007
Last updated
08/22/2020
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