| Gavin J. Miller, Dds, Inc. | |
|
4130 La Jolla Village Dr Ste 205 La Jolla CA 92037-1480 | |
| (858) 546-7667 | |
| (858) 546-7693 |
| Full Name | Gavin J. Miller, Dds, Inc. |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 4130 La Jolla Village Dr Ste 205, La Jolla, California |
| Authorized Official Name and Position | Gavin Jacob Miller (PRESIDENT) |
| Authorized Official Contact | 8585467667 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Gavin J. Miller, Dds, Inc. 4130 La Jolla Village Dr Ste 205 La Jolla CA 92037-1480 Ph: (858) 546-7667 | Gavin J. Miller, Dds, Inc. 4130 La Jolla Village Dr Ste 205 La Jolla CA 92037-1480 Ph: (858) 546-7667 |
| NPI Number | 1043566672 |
|---|---|
| Provider Enumeration Date | 08/01/2012 |
| Last Update Date | 08/01/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1043566672 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 42367 (California) | Primary |
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