Provider Demographics
NPI:1083287494
Name:MILLER, MARIA M (DA)
Entity Type:Individual
Prefix:
First Name:MARIA
Middle Name:M
Last Name:MILLER
Suffix:
Gender:F
Credentials:DA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4755 PASTURE RD BLDG 299
Mailing Address - Street 2:
Mailing Address - City:FALLON
Mailing Address - State:NV
Mailing Address - Zip Code:89406-3491
Mailing Address - Country:US
Mailing Address - Phone:775-426-2811
Mailing Address - Fax:
Practice Address - Street 1:4755 PASTURE RD BLDG 299
Practice Address - Street 2:
Practice Address - City:FALLON
Practice Address - State:NV
Practice Address - Zip Code:89406-3491
Practice Address - Country:US
Practice Address - Phone:775-426-2811
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-07-22
Last Update Date:2021-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes126800000XDental ProvidersDental Assistant