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General NPI Number Information
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NPI Number | 1891177200
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Entity Type | Organization
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Legal Business Name | CLINTON S. MILLER P.C.
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Dates
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Enumeration Date | 06/22/2015
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Last Update Date | 04/11/2023
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Provider Practice Location Address
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Address Line | 302 2ND AVE SW
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City | JAMESTOWN
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State | ND
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Zip | 58401-4157
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Country | US
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Telephone | 701-252-1661
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Fax | 701-252-1228
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Provider Business Mailing Address
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Address Line | 302 2ND AVE SW
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City | JAMESTOWN
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State | ND
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Zip | 58401-4157
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Country | US
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Telephone | 701-252-1661
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Fax | 701-252-1228
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. CLINTON S MILLER
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Credential | DMD
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Telephone | 701-252-1661
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 2227
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License Number State | ND
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Taxonomy #2
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number |
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License Number State |
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