Provider Demographics
NPI:1801397351
Name:MILNER ASSOCIATES, LLC
Entity Type:Organization
Organization Name:MILNER ASSOCIATES, LLC
Other - Org Name:MILNER ASSOCIATES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:JACOB
Authorized Official - Middle Name:PORTMAN
Authorized Official - Last Name:MILNER
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:301-538-4168
Mailing Address - Street 1:11155 DOLFIELD BLVD STE 204
Mailing Address - Street 2:
Mailing Address - City:OWINGS MILLS
Mailing Address - State:MD
Mailing Address - Zip Code:21117-3288
Mailing Address - Country:US
Mailing Address - Phone:410-902-4110
Mailing Address - Fax:
Practice Address - Street 1:11155 DOLFIELD BLVD STE 204
Practice Address - Street 2:
Practice Address - City:OWINGS MILLS
Practice Address - State:MD
Practice Address - Zip Code:21117-3288
Practice Address - Country:US
Practice Address - Phone:410-902-4110
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-02-21
Last Update Date:2018-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD1223G0001XOtherGENERAL DENTIST