Provider Demographics
NPI:1275620213
Name:LUISA MILO DDS LLC
Entity Type:Organization
Organization Name:LUISA MILO DDS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:LUISA
Authorized Official - Middle Name:M
Authorized Official - Last Name:MILO
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:201-760-1116
Mailing Address - Street 1:42 W ALLENDALE AVE
Mailing Address - Street 2:
Mailing Address - City:ALLENDALE
Mailing Address - State:NJ
Mailing Address - Zip Code:07401
Mailing Address - Country:US
Mailing Address - Phone:201-760-1116
Mailing Address - Fax:201-760-1134
Practice Address - Street 1:42 W ALLENDALE AVE
Practice Address - Street 2:
Practice Address - City:ALLENDALE
Practice Address - State:NJ
Practice Address - Zip Code:07401
Practice Address - Country:US
Practice Address - Phone:201-760-1116
Practice Address - Fax:201-760-1134
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-10
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJDI20217122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty