Provider Demographics
NPI:1639295496
Name:MCMILLIN, JAMES T (DDS)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:T
Last Name:MCMILLIN
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 1:7185 DAYTON SPRINGFIELD RD
Mailing Address - Street 2:P O BOX 338
Mailing Address - City:ENON
Mailing Address - State:OH
Mailing Address - Zip Code:45323-1467
Mailing Address - Country:US
Mailing Address - Phone:937-864-2341
Mailing Address - Fax:937-864-1997
Practice Address - Street 1:7185 DAYTON SPRINGFIELD RD
Practice Address - Street 2:WEST ENON MEDICAL CENTER
Practice Address - City:ENON
Practice Address - State:OH
Practice Address - Zip Code:45323-1467
Practice Address - Country:US
Practice Address - Phone:937-864-2341
Practice Address - Fax:937-864-1997
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH300125241223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice