Provider Demographics
NPI:1598862260
Name:MILLER, DONALD BRENT (DDS)
Entity Type:Individual
Prefix:DR
First Name:DONALD
Middle Name:BRENT
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 1:7670 W SAHARA AVE STE 1
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89117-2751
Mailing Address - Country:US
Mailing Address - Phone:702-870-6881
Mailing Address - Fax:702-838-5154
Practice Address - Street 1:7670 W SAHARA AVE STE 1
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89117-2751
Practice Address - Country:US
Practice Address - Phone:702-870-6881
Practice Address - Fax:702-838-5154
Is Sole Proprietor?:No
Enumeration Date:2006-09-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV24951223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice