Provider Demographics
NPI:1932201688
Name:MILLER, ROBERT (DDS)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:
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 1:480 BRIARGATE DR
Mailing Address - Street 2:
Mailing Address - City:SOUTH ELGIN
Mailing Address - State:IL
Mailing Address - Zip Code:60177-2225
Mailing Address - Country:US
Mailing Address - Phone:847-841-1818
Mailing Address - Fax:847-301-1981
Practice Address - Street 1:1149 SAVANNAH HWY STE 305
Practice Address - Street 2:
Practice Address - City:CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29407-7819
Practice Address - Country:US
Practice Address - Phone:843-213-6881
Practice Address - Fax:843-277-1971
Is Sole Proprietor?:No
Enumeration Date:2006-09-02
Last Update Date:2025-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC93951223G0001X
IL93951223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice