Provider Demographics
NPI:1710189535
Name:MILLER, ROBERT JEFFREY (DDS)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:JEFFREY
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 1:16244 MILITARY TRL
Mailing Address - Street 2:STE 260
Mailing Address - City:DELRAY BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33484-6534
Mailing Address - Country:US
Mailing Address - Phone:561-499-5665
Mailing Address - Fax:561-381-7775
Practice Address - Street 1:16244 MILITARY TRL
Practice Address - Street 2:STE 260
Practice Address - City:DELRAY BEACH
Practice Address - State:FL
Practice Address - Zip Code:33484-6534
Practice Address - Country:US
Practice Address - Phone:561-499-5665
Practice Address - Fax:561-381-7775
Is Sole Proprietor?:No
Enumeration Date:2007-06-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9285122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist