| Steven K Miner | |
|
10409 Boney Ave Diberville MS 39540-4813 | |
| (228) 424-0145 | |
| Not Available |
| Full Name | Steven K Miner |
|---|---|
| Speciality | Dentist |
| Location | 10409 Boney Ave, Diberville, Mississippi |
| Authorized Official Name and Position | Steve Kennard Miner (OWNER) |
| Authorized Official Contact | 2284240145 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Steven K Miner 106 Halstead Rd Ocean Springs MS 39564-5315 Ph: (228) 424-0145 | Steven K Miner 10409 Boney Ave Diberville MS 39540-4813 Ph: (228) 424-0145 |
| NPI Number | 1023485851 |
|---|---|
| Provider Enumeration Date | 08/27/2015 |
| Last Update Date | 08/27/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1023485851 | NPI | - | NPPES |
| 0064394 | Medicaid | MS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 202583 (Mississippi) | Primary |
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