Provider Demographics
NPI:1821589037
Name:EDWARD B. MILLER, D.D.S.
Entity Type:Organization
Organization Name:EDWARD B. MILLER, D.D.S.
Other - Org Name:EDWARD B. MILLER, D.D.S. AND ASSOCIATES P.A.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DOCTOR/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:EDWARD
Authorized Official - Middle Name:
Authorized Official - Last Name:MILLER
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:972-298-6131
Mailing Address - Street 1:410 W WHEATLAND RD
Mailing Address - Street 2:
Mailing Address - City:DUNCANVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:75116-4620
Mailing Address - Country:US
Mailing Address - Phone:972-298-6131
Mailing Address - Fax:972-296-7887
Practice Address - Street 1:410 W WHEATLAND RD
Practice Address - Street 2:
Practice Address - City:DUNCANVILLE
Practice Address - State:TX
Practice Address - Zip Code:75116-4620
Practice Address - Country:US
Practice Address - Phone:972-298-6131
Practice Address - Fax:972-296-7887
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-05-23
Last Update Date:2018-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX21331261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental