Provider Demographics
NPI:1538698303
Name:ELIZABETH E MILLER DDS MS PA
Entity Type:Organization
Organization Name:ELIZABETH E MILLER DDS MS PA
Other - Org Name:ROCKY MOUNT PEDIATRIC DENTISTRY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:CAROL
Authorized Official - Middle Name:J
Authorized Official - Last Name:WEBB
Authorized Official - Suffix:
Authorized Official - Credentials:OM
Authorized Official - Phone:252-937-5823
Mailing Address - Street 1:73 SUCCESS CT
Mailing Address - Street 2:
Mailing Address - City:ROCKY MOUNT
Mailing Address - State:NC
Mailing Address - Zip Code:27804-1787
Mailing Address - Country:US
Mailing Address - Phone:252-937-5823
Mailing Address - Fax:252-451-1386
Practice Address - Street 1:73 SUCCESS CT
Practice Address - Street 2:
Practice Address - City:ROCKY MOUNT
Practice Address - State:NC
Practice Address - Zip Code:27804-1787
Practice Address - Country:US
Practice Address - Phone:252-937-5823
Practice Address - Fax:252-451-1386
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-06-06
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC84541223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0221XDental ProvidersDentistPediatric DentistryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC1528258290OtherINDIVIDUAL NPI