Provider Demographics
NPI:1376631234
Name:MILLER, ANNE W (DMD)
Entity Type:Individual
Prefix:DR
First Name:ANNE
Middle Name:W
Last Name:MILLER
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:840 N 87TH ST
Mailing Address - Street 2:STE 2169
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53226-3586
Mailing Address - Country:US
Mailing Address - Phone:414-805-5781
Mailing Address - Fax:414-259-9115
Practice Address - Street 1:840 N 87TH ST
Practice Address - Street 2:STE 2169
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53226-3586
Practice Address - Country:US
Practice Address - Phone:414-805-5781
Practice Address - Fax:414-259-9115
Is Sole Proprietor?:No
Enumeration Date:2006-10-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MS3304-041223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery