Provider Demographics
NPI:1174639868
Name:MILLER, BRUCE A (DMD)
Entity Type:Individual
Prefix:DR
First Name:BRUCE
Middle Name:A
Last Name:MILLER
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 1:890 POPLAR CHURCH RD
Mailing Address - Street 2:SUITE 404
Mailing Address - City:CAMP HILL
Mailing Address - State:PA
Mailing Address - Zip Code:17011-2250
Mailing Address - Country:US
Mailing Address - Phone:717-761-2453
Mailing Address - Fax:717-761-2350
Practice Address - Street 1:890 POPLAR CHURCH RD
Practice Address - Street 2:SUITE 404
Practice Address - City:CAMP HILL
Practice Address - State:PA
Practice Address - Zip Code:17011-2250
Practice Address - Country:US
Practice Address - Phone:717-761-2453
Practice Address - Fax:717-761-2350
Is Sole Proprietor?:No
Enumeration Date:2006-08-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS020101-L122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist