Provider Demographics
NPI:1972712768
Name:MILLER, WILLIAM W KENDALL III (DDS, MS, PA)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:W KENDALL
Last Name:MILLER
Suffix:III
Gender:M
Credentials:DDS, MS, PA
Other - Prefix:DR
Other - First Name:W. KENDALL
Other - Middle Name:
Other - Last Name:MILLER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DDS, MS, PA
Mailing Address - Street 1:690 RITCHIE HWY
Mailing Address - Street 2:
Mailing Address - City:SEVERNA PARK
Mailing Address - State:MD
Mailing Address - Zip Code:21146-3919
Mailing Address - Country:US
Mailing Address - Phone:410-647-0800
Mailing Address - Fax:410-544-3652
Practice Address - Street 1:690 RITCHIE HWY
Practice Address - Street 2:
Practice Address - City:SEVERNA PARK
Practice Address - State:MD
Practice Address - Zip Code:21146-3919
Practice Address - Country:US
Practice Address - Phone:410-647-0800
Practice Address - Fax:410-544-3652
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-21
Last Update Date:2007-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD120061223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics