DR. Glen R Miller, DDS

NPI #1891782892 in Fairfax, Virginia

Provider Information

NPI Number: 1891782892
Entity Type: Individual
Name: DR. Glen R Miller, DDS
Gender: Not Specified
Sole Proprietor: Not Answered
Primary Specialty: Dentist - General Practice
Credential: DDS
Enumeration Date: Oct 4, 2005
Last Updated: Jul 8, 2007

Practice Location

Address: 10509 BRADDOCK RD
City: Fairfax
State: Virginia
ZIP Code: 22032-2239
Phone: (703) 503-1700

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist - General Practice — General Practice	1223G0001X	Primary

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