Provider Demographics
NPI:1790982924
Name:MILLER, NOAH MARCUS (DMD)
Entity Type:Individual
Prefix:DR
First Name:NOAH
Middle Name:MARCUS
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 1:2729 RAINBOW DRIVE
Mailing Address - Street 2:
Mailing Address - City:RAINBOW CITY
Mailing Address - State:AL
Mailing Address - Zip Code:35906
Mailing Address - Country:US
Mailing Address - Phone:205-249-8537
Mailing Address - Fax:
Practice Address - Street 1:2450 PEPPERRELL ST
Practice Address - Street 2:
Practice Address - City:LACKLAND A F B
Practice Address - State:TX
Practice Address - Zip Code:78236-5345
Practice Address - Country:US
Practice Address - Phone:210-292-6990
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program