Provider Demographics
NPI:1558492777
Name:MILLS, DAVID W (DDS)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:W
Last Name:MILLS
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 1:26300 EUCLID AVE
Mailing Address - Street 2:SUITE 520
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44132-3708
Mailing Address - Country:US
Mailing Address - Phone:216-261-2580
Mailing Address - Fax:216-732-9176
Practice Address - Street 1:26300 EUCLID AVE
Practice Address - Street 2:SUITE 520
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44132-3708
Practice Address - Country:US
Practice Address - Phone:216-261-2580
Practice Address - Fax:216-732-9176
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH30-01-60991223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice