Provider Demographics
NPI:1073050829
Name:NOAH D. MILLER DMD LLC
Entity Type:Organization
Organization Name:NOAH D. MILLER DMD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:NOAH
Authorized Official - Middle Name:DEAN
Authorized Official - Last Name:MILLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:256-442-8081
Mailing Address - Street 1:2729 RAINBOW DR
Mailing Address - Street 2:
Mailing Address - City:RAINBOW CITY
Mailing Address - State:AL
Mailing Address - Zip Code:35906-5815
Mailing Address - Country:US
Mailing Address - Phone:256-442-8081
Mailing Address - Fax:256-442-8082
Practice Address - Street 1:2729 RAINBOW DR
Practice Address - Street 2:
Practice Address - City:RAINBOW CITY
Practice Address - State:AL
Practice Address - Zip Code:35906-5815
Practice Address - Country:US
Practice Address - Phone:256-442-8081
Practice Address - Fax:256-442-8082
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:NOAH D. MILLER DMD LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2017-01-31
Last Update Date:2017-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL3444AL261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center