Provider Demographics
NPI:1568781896
Name:MEGAN R MILLER, DDS, PS
Entity Type:Organization
Organization Name:MEGAN R MILLER, DDS, PS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:MEGAN
Authorized Official - Middle Name:ROCHELLE
Authorized Official - Last Name:MILLER
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:253-272-2900
Mailing Address - Street 1:2312 N 30TH ST
Mailing Address - Street 2:SUITE 202
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98403-3356
Mailing Address - Country:US
Mailing Address - Phone:253-272-2900
Mailing Address - Fax:253-404-0684
Practice Address - Street 1:2312 N 30TH ST
Practice Address - Street 2:SUITE 202
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98403-3356
Practice Address - Country:US
Practice Address - Phone:253-272-2900
Practice Address - Fax:253-404-0684
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-05-26
Last Update Date:2010-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADE 000093481223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty