Provider Demographics
NPI:1538784640
Name:MILLER, JOSEPH GEORGE (DMD)
Entity type:Individual
Prefix:
First Name:JOSEPH
Middle Name:GEORGE
Last Name:MILLER
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:263 BAMBERG DR
Mailing Address - Street 2:
Mailing Address - City:BLUFFTON
Mailing Address - State:SC
Mailing Address - Zip Code:29910-7401
Mailing Address - Country:US
Mailing Address - Phone:843-368-7214
Mailing Address - Fax:
Practice Address - Street 1:14 OAK FOREST RD STE F
Practice Address - Street 2:
Practice Address - City:BLUFFTON
Practice Address - State:SC
Practice Address - Zip Code:29910-4988
Practice Address - Country:US
Practice Address - Phone:843-757-0504
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-06-15
Last Update Date:2020-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC96491223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice