Provider Demographics
NPI:1518068717
Name:MILLER, ROBERT C (DDS, MED)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:C
Last Name:MILLER
Suffix:
Gender:M
Credentials:DDS, MED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:UNIVERSITY OF OKLAHOMA COLLEGE OF DENTISTRY
Mailing Address - Street 2:1201 N. STONEWALL AVENUE
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73117-1214
Mailing Address - Country:US
Mailing Address - Phone:405-271-5735
Mailing Address - Fax:405-271-3006
Practice Address - Street 1:UNIVERSITY OF OKLAHOMA COLLEGE OF DENTISTRY
Practice Address - Street 2:1201 N. STONEWALL AVE.
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73117-1214
Practice Address - Country:US
Practice Address - Phone:405-271-5735
Practice Address - Fax:405-271-3006
Is Sole Proprietor?:No
Enumeration Date:2006-09-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK4040122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist