Provider Demographics
NPI:1417022724
Name:MILLER, ROBERT PARNELL (DDS MS)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:PARNELL
Last Name:MILLER
Suffix:
Gender:M
Credentials:DDS MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1246 GORMAN AVE
Mailing Address - Street 2:
Mailing Address - City:WEST SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55118-2406
Mailing Address - Country:US
Mailing Address - Phone:651-457-5401
Mailing Address - Fax:
Practice Address - Street 1:1246 GORMAN AVE
Practice Address - Street 2:
Practice Address - City:WEST SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55118-2406
Practice Address - Country:US
Practice Address - Phone:651-457-5401
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MND112461223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics