Provider Demographics
NPI:1306038179
Name:ROBERT A MILLER DMD PC
Entity Type:Organization
Organization Name:ROBERT A MILLER DMD PC
Other - Org Name:MILLER ORTHODONTICS PC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:A
Authorized Official - Last Name:MILLER
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:540-825-6064
Mailing Address - Street 1:1100 SUNSET LANE
Mailing Address - Street 2:SUITE 1110
Mailing Address - City:CULPEPPER
Mailing Address - State:VA
Mailing Address - Zip Code:22701
Mailing Address - Country:US
Mailing Address - Phone:540-825-6064
Mailing Address - Fax:540-825-6067
Practice Address - Street 1:1100 SUNSET LANE
Practice Address - Street 2:SUITE 1110
Practice Address - City:CULPEPPER
Practice Address - State:VA
Practice Address - Zip Code:22701
Practice Address - Country:US
Practice Address - Phone:540-825-6064
Practice Address - Fax:540-825-6067
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-15
Last Update Date:2007-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA04010070171223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty