Provider Demographics
NPI:1053827881
Name:ERNEST P MILLER JR DDS
Entity Type:Organization
Organization Name:ERNEST P MILLER JR DDS
Other - Org Name:ERNEST P MILLER JR. DDS PC
Other - Org Type:Other Name
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:
Authorized Official - First Name:ERNEST
Authorized Official - Middle Name:P
Authorized Official - Last Name:MILLER
Authorized Official - Suffix:JR
Authorized Official - Credentials:DDS
Authorized Official - Phone:210-699-9761
Mailing Address - Street 1:5138 UTSA BLVD STE 116
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78249-3537
Mailing Address - Country:US
Mailing Address - Phone:210-699-9761
Mailing Address - Fax:210-699-0039
Practice Address - Street 1:5138 UTSA BLVD STE 116
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78249-3537
Practice Address - Country:US
Practice Address - Phone:210-699-9761
Practice Address - Fax:210-699-0039
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-12-15
Last Update Date:2017-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX23439261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental