| Organization Name: | RICHARD P MILLER DMD PC |
| NPI Number: | 1043606718 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | RICHARD P MILLER (OWNER) |
| Mailing Address: | 1100 Ne 7th St Ste B Grants Pass |
| State: | OR US |
| Postal Code: | 975261415 |
| Phone Number: | 5414764667 |
| Fax Number: | 5414763669 |
| NPI Enumeration Date: | 04/09/2015 |
| NPI Last Update Date: | 04/09/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QD0000X |
| License Number: | D6459 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | OR |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Dental |
| Taxonomy Definition: | |