Provider Demographics
NPI:1558665372
Name:MILLER, MARGARET ANN (DDS)
Entity Type:Individual
Prefix:DR
First Name:MARGARET
Middle Name:ANN
Last Name:MILLER
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:534 REDBIRD CIR
Mailing Address - Street 2:
Mailing Address - City:DE PERE
Mailing Address - State:WI
Mailing Address - Zip Code:54115-8785
Mailing Address - Country:US
Mailing Address - Phone:920-336-4002
Mailing Address - Fax:920-336-4112
Practice Address - Street 1:534 REDBIRD CIR
Practice Address - Street 2:
Practice Address - City:DE PERE
Practice Address - State:WI
Practice Address - Zip Code:54115-8785
Practice Address - Country:US
Practice Address - Phone:920-336-4002
Practice Address - Fax:920-336-4112
Is Sole Proprietor?:Yes
Enumeration Date:2011-01-09
Last Update Date:2011-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI41761223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry