Provider Demographics
NPI:1093885576
Name:MILLER, NEWELL (DDS)
Entity Type:Individual
Prefix:
First Name:NEWELL
Middle Name:
Last Name:MILLER
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3250 PLYMOUTH RD
Mailing Address - Street 2:SUITE 202
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48105-2592
Mailing Address - Country:US
Mailing Address - Phone:734-761-7830
Mailing Address - Fax:
Practice Address - Street 1:3250 PLYMOUTH RD
Practice Address - Street 2:SUITE 202
Practice Address - City:ANN ARBOR
Practice Address - State:MI
Practice Address - Zip Code:48105-2592
Practice Address - Country:US
Practice Address - Phone:734-761-7830
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI082701223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice