Provider Demographics
NPI:1265674626
Name:MILLS, ERICA A (DDS)
Entity Type:Individual
Prefix:DR
First Name:ERICA
Middle Name:A
Last Name:MILLS
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 1:244 FIFTH AVENUE
Mailing Address - Street 2:SUITE # E-274
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10001
Mailing Address - Country:US
Mailing Address - Phone:718-566-1305
Mailing Address - Fax:718-228-8326
Practice Address - Street 1:1718 PITKIN AVENUE
Practice Address - Street 2:SUITE # 117
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11212
Practice Address - Country:US
Practice Address - Phone:718-566-1305
Practice Address - Fax:718-228-8326
Is Sole Proprietor?:Yes
Enumeration Date:2009-04-01
Last Update Date:2015-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY055304-1122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist