Provider Demographics
NPI:1851397111
Name:MILLER, V TERRY (DDS)
Entity Type:Individual
Prefix:DR
First Name:V
Middle Name:TERRY
Last Name:MILLER
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:DR
Other - First Name:VERNON
Other - Middle Name:T
Other - Last Name:MILLER
Other - Suffix:JR
Other - Last Name Type:Former Name
Other - Credentials:DDS
Mailing Address - Street 1:1130 BEACHVIEW ST
Mailing Address - Street 2:SUITE 210
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75218-3706
Mailing Address - Country:US
Mailing Address - Phone:214-321-5800
Mailing Address - Fax:214-321-3156
Practice Address - Street 1:1130 BEACHVIEW ST
Practice Address - Street 2:SUITE 210
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75218-3706
Practice Address - Country:US
Practice Address - Phone:214-321-5800
Practice Address - Fax:214-321-3156
Is Sole Proprietor?:No
Enumeration Date:2005-06-22
Last Update Date:2015-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX146691223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
752537162OtherFEDERAL EIN