Provider Demographics
NPI:1164543393
Name:MILLER, GEORGE CREED (DMD)
Entity Type:Individual
Prefix:DR
First Name:GEORGE
Middle Name:CREED
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:PO BOX 429
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34106-0429
Mailing Address - Country:US
Mailing Address - Phone:239-252-5329
Mailing Address - Fax:239-252-5653
Practice Address - Street 1:3301 TAMIAMI TRL E
Practice Address - Street 2:BUILDING H
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34112-3969
Practice Address - Country:US
Practice Address - Phone:239-252-5329
Practice Address - Fax:239-252-5653
Is Sole Proprietor?:No
Enumeration Date:2007-04-03
Last Update Date:2007-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN60711223G0001X, 1223D0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223D0001XDental ProvidersDentistDental Public Health
No1223G0001XDental ProvidersDentistGeneral Practice