Provider Demographics
NPI:1679683932
Name:MILLER, JAMES BRADLEY (DMD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:BRADLEY
Last Name:MILLER
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9821 N 95TH ST
Mailing Address - Street 2:SUITE 110
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85258-4589
Mailing Address - Country:US
Mailing Address - Phone:480-451-5435
Mailing Address - Fax:480-451-5384
Practice Address - Street 1:9821 N 95TH ST
Practice Address - Street 2:SUITE 110
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85258-4589
Practice Address - Country:US
Practice Address - Phone:480-451-5435
Practice Address - Fax:480-451-5384
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ4692122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist