Provider Demographics
NPI:1083689640
Name:MILLEN, DAVID D (DMD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:D
Last Name:MILLEN
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:560 MAIN STREET
Mailing Address - Street 2:
Mailing Address - City:ANSONIA
Mailing Address - State:CT
Mailing Address - Zip Code:06401
Mailing Address - Country:US
Mailing Address - Phone:203-732-0097
Mailing Address - Fax:888-836-4899
Practice Address - Street 1:560 MAIN STREET
Practice Address - Street 2:
Practice Address - City:ANSONIA
Practice Address - State:CT
Practice Address - Zip Code:06401
Practice Address - Country:US
Practice Address - Phone:203-732-0097
Practice Address - Fax:888-836-4899
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-17
Last Update Date:2016-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0041831223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics