Provider Demographics
NPI:1629185079
Name:MILLER, JEFFREY S (DDS)
Entity Type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:S
Last Name:MILLER
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7648 MORGAN RD
Mailing Address - Street 2:
Mailing Address - City:CLEVES
Mailing Address - State:OH
Mailing Address - Zip Code:45002-9772
Mailing Address - Country:US
Mailing Address - Phone:513-353-2228
Mailing Address - Fax:
Practice Address - Street 1:10530 HARRISON AVE
Practice Address - Street 2:SUITE B
Practice Address - City:HARRISON
Practice Address - State:OH
Practice Address - Zip Code:45030-2141
Practice Address - Country:US
Practice Address - Phone:513-367-2999
Practice Address - Fax:513-367-0000
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH190821223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice