Individual
DR. GLEN R MILLER
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
10509 BRADDOCK RD, FAIRFAX, VA 22032-2239
(703) 503-1700
(703) 503-0766
Mailing address
5249 DUKE ST, ALEXANDRIA, VA 22304-2919
(703) 212-7500
(703) 212-7056
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
0401008691
VA
Other
Enumeration date
10/04/2005
Last updated
07/08/2007
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