Provider Demographics
NPI:1437904745
Name:MILLER, SYDNEY B (DMD)
Entity Type:Individual
Prefix:
First Name:SYDNEY
Middle Name:B
Last Name:MILLER
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:620 WALNUT ST
Mailing Address - Street 2:
Mailing Address - City:DUNELLEN
Mailing Address - State:NJ
Mailing Address - Zip Code:08812-1426
Mailing Address - Country:US
Mailing Address - Phone:732-882-9263
Mailing Address - Fax:
Practice Address - Street 1:17411 HORACE HARDING EXPY
Practice Address - Street 2:
Practice Address - City:FRESH MEADOWS
Practice Address - State:NY
Practice Address - Zip Code:11365-1527
Practice Address - Country:US
Practice Address - Phone:718-670-1060
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-19
Last Update Date:2024-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program