Provider Demographics
NPI:1588825210
Name:MILLER, WILLIAM JOSEPH (DDS)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:JOSEPH
Last Name:MILLER
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 1:4124 FULTON DR NW
Mailing Address - Street 2:SUITE 201
Mailing Address - City:CANTON
Mailing Address - State:OH
Mailing Address - Zip Code:44718-2852
Mailing Address - Country:US
Mailing Address - Phone:330-493-3595
Mailing Address - Fax:330-493-3597
Practice Address - Street 1:4124 FULTON DR NW
Practice Address - Street 2:SUITE 201
Practice Address - City:CANTON
Practice Address - State:OH
Practice Address - Zip Code:44718-2852
Practice Address - Country:US
Practice Address - Phone:330-493-3595
Practice Address - Fax:330-493-3597
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-25
Last Update Date:2008-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH171061223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice