Provider Demographics
NPI:1003263690
Name:MILLER, RACHAEL (DMD)
Entity Type:Individual
Prefix:
First Name:RACHAEL
Middle Name:
Last Name:MILLER
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:890 POPLAR CHURCH RD
Mailing Address - Street 2:SUITE 404
Mailing Address - City:CAMP HILL
Mailing Address - State:PA
Mailing Address - Zip Code:17011
Mailing Address - Country:US
Mailing Address - Phone:717-761-2453
Mailing Address - Fax:
Practice Address - Street 1:253 N HERSHEY RD
Practice Address - Street 2:
Practice Address - City:HARRISBURG
Practice Address - State:PA
Practice Address - Zip Code:17112-9752
Practice Address - Country:US
Practice Address - Phone:717-974-3487
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-05-24
Last Update Date:2022-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
PADS0411821223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program