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General NPI Number Information
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NPI Number | 1861539785
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Entity Type | Individual
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Provider Name | GARY WARREN MILLER DDS
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Gender | Male
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Dates
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Enumeration Date | 01/31/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 615 E OKLAHOMA AVE SUITE 102
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City | ENID
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State | OK
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Zip | 73701-5951
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Country | US
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Telephone | 580-242-1500
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Fax |
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Provider Business Mailing Address
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Address Line | 615 E OKLAHOMA SUITE 102 DR GARY W MILLER DDS
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City | ENID
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State | OK
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Zip | 73701
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Country | US
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Telephone | 580-242-1500
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Fax | 580-242-0029
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223S0112X
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Taxonomy Name | Oral and Maxillofacial Surgery (Dentist)
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License Number | 3640
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License Number State | OK
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