Provider Demographics
NPI:1093746992
Name:MILLER, DON R (DDS)
Entity Type:Individual
Prefix:DR
First Name:DON
Middle Name:R
Last Name:MILLER
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Mailing Address - Street 1:1115 VINE ST
Mailing Address - Street 2:
Mailing Address - City:PASO ROBLES
Mailing Address - State:CA
Mailing Address - Zip Code:93446-2560
Mailing Address - Country:US
Mailing Address - Phone:805-238-2632
Mailing Address - Fax:805-238-6027
Practice Address - Street 1:1115 VINE ST
Practice Address - Street 2:
Practice Address - City:PASO ROBLES
Practice Address - State:CA
Practice Address - Zip Code:93446-2560
Practice Address - Country:US
Practice Address - Phone:805-238-2632
Practice Address - Fax:805-238-6027
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAD217321223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics