Provider Demographics
NPI:1376220632
Name:MILLER SKINNER DENTAL CORPORATION OF NORTH MERCED
Entity Type:Organization
Organization Name:MILLER SKINNER DENTAL CORPORATION OF NORTH MERCED
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:NATHAN
Authorized Official - Middle Name:
Authorized Official - Last Name:MILLER
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:480-452-3022
Mailing Address - Street 1:1132 OLIVEWOOD DR.
Mailing Address - Street 2:
Mailing Address - City:MERCED
Mailing Address - State:CA
Mailing Address - Zip Code:95348
Mailing Address - Country:US
Mailing Address - Phone:209-722-3961
Mailing Address - Fax:209-722-6197
Practice Address - Street 1:1132 OLIVEWOOD DR.
Practice Address - Street 2:
Practice Address - City:MERCED
Practice Address - State:CA
Practice Address - Zip Code:95348
Practice Address - Country:US
Practice Address - Phone:209-722-3961
Practice Address - Fax:209-722-6197
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MILLER SKINNER DENTAL CORPORATION OF NORTH MERCED
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-06-29
Last Update Date:2023-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty