Provider Demographics
NPI:1275154478
Name:MILLER, BRITTANY JOELLE
Entity Type:Individual
Prefix:
First Name:BRITTANY
Middle Name:JOELLE
Last Name:MILLER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:130 ALMSHOUSE RD STE 500
Mailing Address - Street 2:
Mailing Address - City:RICHBORO
Mailing Address - State:PA
Mailing Address - Zip Code:18954-1133
Mailing Address - Country:US
Mailing Address - Phone:215-322-0440
Mailing Address - Fax:
Practice Address - Street 1:130 ALMSHOUSE RD STE 500
Practice Address - Street 2:
Practice Address - City:RICHBORO
Practice Address - State:PA
Practice Address - Zip Code:18954-1133
Practice Address - Country:US
Practice Address - Phone:215-322-0400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-04-29
Last Update Date:2022-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
PA0426851223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program