Provider Demographics
NPI:1578543898
Name:MILLER, STUART O (DDS)
Entity Type:Individual
Prefix:DR
First Name:STUART
Middle Name:O
Last Name:MILLER
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:200 DOCTORS DRIVE
Mailing Address - Street 2:SUITE G
Mailing Address - City:JACKSONVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28546
Mailing Address - Country:US
Mailing Address - Phone:910-577-4330
Mailing Address - Fax:910-577-3405
Practice Address - Street 1:315 MCHUGH BLVD
Practice Address - Street 2:
Practice Address - City:CAMP LEJEUNE
Practice Address - State:NC
Practice Address - Zip Code:28547-2511
Practice Address - Country:US
Practice Address - Phone:910-451-1013
Practice Address - Fax:910-451-4194
Is Sole Proprietor?:No
Enumeration Date:2006-01-20
Last Update Date:2022-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC58311223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics