Provider Demographics
NPI:1578782702
Name:MILLER, ROBERT BURKE (DMD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:BURKE
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 1:901 E 66TH ST
Mailing Address - Street 2:
Mailing Address - City:SAVANNAH
Mailing Address - State:GA
Mailing Address - Zip Code:31405-4509
Mailing Address - Country:US
Mailing Address - Phone:912-525-7777
Mailing Address - Fax:912-525-7779
Practice Address - Street 1:901 E 66TH ST
Practice Address - Street 2:
Practice Address - City:SAVANNAH
Practice Address - State:GA
Practice Address - Zip Code:31405-4510
Practice Address - Country:US
Practice Address - Phone:912-525-7777
Practice Address - Fax:912-525-7779
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-25
Last Update Date:2015-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA0120551223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice