Provider Demographics
NPI:1134330798
Name:MATTHEW MILLER DDS PLLC
Entity Type:Organization
Organization Name:MATTHEW MILLER DDS PLLC
Other - Org Name:VERY GENTLE FAMILY DENTISTRY
Other - Org Type:Other Name
Authorized Official - Title/Position:OWNER OF DENTAL PRACTICE
Authorized Official - Prefix:MR
Authorized Official - First Name:MATTHEW
Authorized Official - Middle Name:KEITH
Authorized Official - Last Name:MILLER
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:304-598-0400
Mailing Address - Street 1:5000 HAMPTON CENTER
Mailing Address - Street 2:SUITE 2
Mailing Address - City:MORGANTOWN
Mailing Address - State:WV
Mailing Address - Zip Code:26505-1709
Mailing Address - Country:US
Mailing Address - Phone:304-598-0400
Mailing Address - Fax:304-598-0444
Practice Address - Street 1:5000 HAMPTON CENTER
Practice Address - Street 2:SUITE 2
Practice Address - City:MORGANTOWN
Practice Address - State:WV
Practice Address - Zip Code:26505-1709
Practice Address - Country:US
Practice Address - Phone:304-598-0400
Practice Address - Fax:304-598-0444
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-25
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WVWV34961223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty