Provider Demographics
NPI:1003098955
Name:MILLER, PATRICIA S (DDS)
Entity Type:Individual
Prefix:DR
First Name:PATRICIA
Middle Name:S
Last Name:MILLER
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5095 ST RT 54
Mailing Address - Street 2:
Mailing Address - City:TURBOTVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:17772
Mailing Address - Country:US
Mailing Address - Phone:570-649-6145
Mailing Address - Fax:570-649-6145
Practice Address - Street 1:5095 ST RT 54
Practice Address - Street 2:
Practice Address - City:TURBOTVILLE
Practice Address - State:PA
Practice Address - Zip Code:17772
Practice Address - Country:US
Practice Address - Phone:570-649-6145
Practice Address - Fax:570-649-6145
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-03
Last Update Date:2007-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS021171L1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice