Individual
KALE BRENT MCMILLAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD, DDS
Taxonomy
Speciality
Code
Description
License number
State
1223P0700X
Prosthodontics
R639
MN
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
2901602012
MI
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
D13963
MN
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
72000
MN
390200000X
Student in an Organized Health Care Education/Training Program
2901602012
MI
Other
Enumeration date
08/31/2015
Last updated
07/03/2025
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