Provider Demographics
NPI:1235369158
Name:MCMILLAN, DUGALD RICHARD IV (DMD)
Entity Type:Individual
Prefix:DR
First Name:DUGALD
Middle Name:RICHARD
Last Name:MCMILLAN
Suffix:IV
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 1:2306 WILDRIDGE CIR
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35216-1276
Mailing Address - Country:US
Mailing Address - Phone:205-215-9777
Mailing Address - Fax:
Practice Address - Street 1:5291 VALLEYDALE RD STE 129
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35242-7707
Practice Address - Country:US
Practice Address - Phone:205-995-3989
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-27
Last Update Date:2009-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL56911223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice