Provider Demographics
NPI:1629138508
Name:MILLER, KARIN (DMD)
Entity Type:Individual
Prefix:
First Name:KARIN
Middle Name:
Last Name:MILLER
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1943 MERRIMAC DR
Mailing Address - Street 2:
Mailing Address - City:TOMS RIVER
Mailing Address - State:NJ
Mailing Address - Zip Code:08753-3190
Mailing Address - Country:US
Mailing Address - Phone:732-929-0413
Mailing Address - Fax:
Practice Address - Street 1:169 N MAIN ST
Practice Address - Street 2:
Practice Address - City:MANAHAWKIN
Practice Address - State:NJ
Practice Address - Zip Code:08050-2933
Practice Address - Country:US
Practice Address - Phone:609-597-6990
Practice Address - Fax:609-597-2013
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22D1015476001223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice