Provider Demographics
NPI:1043410152
Name:MILLER, TAMMIE K NEAL (DDS)
Entity Type:Individual
Prefix:MRS
First Name:TAMMIE
Middle Name:K NEAL
Last Name:MILLER
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:DR
Other - First Name:TAMMIE
Other - Middle Name:K
Other - Last Name:NEAL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DDS
Mailing Address - Street 1:2325 VALOR DRIVE
Mailing Address - Street 2:
Mailing Address - City:WINCHESTER
Mailing Address - State:VA
Mailing Address - Zip Code:22601
Mailing Address - Country:US
Mailing Address - Phone:540-450-8888
Mailing Address - Fax:540-526-9696
Practice Address - Street 1:2325 VALOR DRIVE
Practice Address - Street 2:
Practice Address - City:WINCHESTER
Practice Address - State:VA
Practice Address - Zip Code:22601
Practice Address - Country:US
Practice Address - Phone:540-450-8888
Practice Address - Fax:540-526-9696
Is Sole Proprietor?:No
Enumeration Date:2007-07-18
Last Update Date:2014-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA04010086791223G0001X, 122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No1223G0001XDental ProvidersDentistGeneral Practice