Provider Demographics
NPI:1821518937
Name:MILLER, RICK MICHAEL (MEDICAL DENTURITRY)
Entity Type:Individual
Prefix:DR
First Name:RICK
Middle Name:MICHAEL
Last Name:MILLER
Suffix:
Gender:M
Credentials:MEDICAL DENTURITRY
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:924 6TH AVE SE
Mailing Address - Street 2:
Mailing Address - City:ABERDEEN
Mailing Address - State:SD
Mailing Address - Zip Code:57401-6375
Mailing Address - Country:US
Mailing Address - Phone:605-725-0042
Mailing Address - Fax:605-725-0042
Practice Address - Street 1:924 6TH AVE SE
Practice Address - Street 2:
Practice Address - City:ABERDEEN
Practice Address - State:SD
Practice Address - Zip Code:57401-6375
Practice Address - Country:US
Practice Address - Phone:605-725-0042
Practice Address - Fax:605-725-0042
Is Sole Proprietor?:Yes
Enumeration Date:2017-06-21
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SDUB204630122400000X
WANT003122400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122400000XDental ProvidersDenturist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WANT003OtherTRIBAL LICENSE
SDUB204630OtherLICENSE BUSINESS