Provider Demographics
NPI:1972936458
Name:MILLER, THOMAS MILLER (DDS)
Entity Type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:MILLER
Last Name:MILLER
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:741 HOOSICK RD
Mailing Address - Street 2:
Mailing Address - City:TROY
Mailing Address - State:NY
Mailing Address - Zip Code:12180-6626
Mailing Address - Country:US
Mailing Address - Phone:518-273-0089
Mailing Address - Fax:518-273-0353
Practice Address - Street 1:741 HOOSICK RD
Practice Address - Street 2:
Practice Address - City:TROY
Practice Address - State:NY
Practice Address - Zip Code:12180-6626
Practice Address - Country:US
Practice Address - Phone:518-273-0089
Practice Address - Fax:518-273-0353
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-20
Last Update Date:2013-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY038522122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist