Provider Demographics
NPI:1750482105
Name:DEEG, MILES FREDERIC JR (DDS)
Entity Type:Individual
Prefix:DR
First Name:MILES
Middle Name:FREDERIC
Last Name:DEEG
Suffix:JR
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 1:14991 E HAMPDEN
Mailing Address - Street 2:SUITE 390
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80014
Mailing Address - Country:US
Mailing Address - Phone:303-690-6662
Mailing Address - Fax:303-690-9699
Practice Address - Street 1:14991 E HAMPDEN
Practice Address - Street 2:SUITE 390
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80014
Practice Address - Country:US
Practice Address - Phone:303-690-6662
Practice Address - Fax:303-690-9699
Is Sole Proprietor?:No
Enumeration Date:2006-09-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO06593122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist