Provider Demographics
NPI:1225352883
Name:MILLER, JOANN MARIE (DDS)
Entity Type:Individual
Prefix:DR
First Name:JOANN
Middle Name:MARIE
Last Name:MILLER
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 RIVER PL
Mailing Address - Street 2:
Mailing Address - City:MONONA
Mailing Address - State:WI
Mailing Address - Zip Code:53716-4041
Mailing Address - Country:US
Mailing Address - Phone:608-222-3231
Mailing Address - Fax:
Practice Address - Street 1:100 RIVER PL
Practice Address - Street 2:
Practice Address - City:MONONA
Practice Address - State:WI
Practice Address - Zip Code:53716-4041
Practice Address - Country:US
Practice Address - Phone:608-222-3231
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-03-25
Last Update Date:2010-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI5647-0151223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice