Provider Demographics
NPI:1891051785
Name:KING, MILES HENRY III (DDS)
Entity Type:Individual
Prefix:DR
First Name:MILES
Middle Name:HENRY
Last Name:KING
Suffix:III
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 1:303 GRANVILLE DR
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20901-3103
Mailing Address - Country:US
Mailing Address - Phone:301-589-5877
Mailing Address - Fax:301-587-7843
Practice Address - Street 1:303 GRANVILLE DR
Practice Address - Street 2:
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20901-3103
Practice Address - Country:US
Practice Address - Phone:301-589-5877
Practice Address - Fax:301-587-7843
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-05
Last Update Date:2012-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD7892122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist