Provider Demographics
NPI:1275754368
Name:STEPHEN D. MILLER, D.D.S., LTD
Entity Type:Organization
Organization Name:STEPHEN D. MILLER, D.D.S., LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:D
Authorized Official - Last Name:MILLER
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:717-569-4597
Mailing Address - Street 1:510 N SCHOOL LN
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:PA
Mailing Address - Zip Code:17603-2533
Mailing Address - Country:US
Mailing Address - Phone:717-393-1345
Mailing Address - Fax:
Practice Address - Street 1:394 EAST ROSEVILLE ROAD
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:PA
Practice Address - Zip Code:17601-3841
Practice Address - Country:US
Practice Address - Phone:717-569-4597
Practice Address - Fax:717-569-2757
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-02
Last Update Date:2007-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA172981223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0221XDental ProvidersDentistPediatric DentistryGroup - Single Specialty