Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 122300000X | Dentist | 2061 | AL |
N | 1223D0001X | Dental Public Health | 2061 | AL |
NPI | 1750555066 |
---|---|
Provider Name | Dr. Andrew J Mills JR. |
First Address | Enterprise, AL 36330-8003 |
Second Address | Enterprise, AL 36330-8003 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/04/2008 |
Last Update Date | 08/05/2008 |