Provider Demographics
NPI:1366501033
Name:MILLER, STEVEN TROY (DDS)
Entity Type:Individual
Prefix:
First Name:STEVEN
Middle Name:TROY
Last Name:MILLER
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:500 DOVER BLVD
Mailing Address - Street 2:SUITE 300
Mailing Address - City:LAFEYETTE
Mailing Address - State:LA
Mailing Address - Zip Code:70503
Mailing Address - Country:US
Mailing Address - Phone:337-984-4747
Mailing Address - Fax:337-984-4751
Practice Address - Street 1:500 DOVER BLVD
Practice Address - Street 2:SUITE 300
Practice Address - City:LAFEYETTE
Practice Address - State:LA
Practice Address - Zip Code:70503
Practice Address - Country:US
Practice Address - Phone:337-984-4747
Practice Address - Fax:337-984-4751
Is Sole Proprietor?:No
Enumeration Date:2006-12-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA53391223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1853399Medicaid