Provider Demographics
NPI:1750476487
Name:MILLER, SCOTT L I (DDS)
Entity Type:Individual
Prefix:DR
First Name:SCOTT
Middle Name:L
Last Name:MILLER
Suffix:I
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 1:5357 S 3675 W
Mailing Address - Street 2:
Mailing Address - City:ROY
Mailing Address - State:UT
Mailing Address - Zip Code:84067-9239
Mailing Address - Country:US
Mailing Address - Phone:801-985-3274
Mailing Address - Fax:
Practice Address - Street 1:5985 S 3500 W
Practice Address - Street 2:
Practice Address - City:ROY
Practice Address - State:UT
Practice Address - Zip Code:84067-9003
Practice Address - Country:US
Practice Address - Phone:801-985-4000
Practice Address - Fax:801-985-4005
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT1443589922122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist