Provider Demographics
NPI:1265505960
Name:MILLER, ROSS JOHN (DDS)
Entity Type:Individual
Prefix:DR
First Name:ROSS
Middle Name:JOHN
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 1:915 W EXCHANGE PKWY
Mailing Address - Street 2:SUITE 200
Mailing Address - City:ALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:75013-7017
Mailing Address - Country:US
Mailing Address - Phone:972-727-1200
Mailing Address - Fax:972-727-1203
Practice Address - Street 1:915 W EXCHANGE PKWY
Practice Address - Street 2:SUITE 200
Practice Address - City:ALLEN
Practice Address - State:TX
Practice Address - Zip Code:75013-7017
Practice Address - Country:US
Practice Address - Phone:972-727-1200
Practice Address - Fax:972-727-1203
Is Sole Proprietor?:No
Enumeration Date:2006-11-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX160781223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice