Provider Demographics
NPI:1124175229
Name:MILLER, FLORICA TUDORAN (DDS)
Entity type:Individual
Prefix:DR
First Name:FLORICA
Middle Name:TUDORAN
Last Name:MILLER
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19333 US RT 11 ,OUTER WASHINGTON STREET,
Mailing Address - Street 2:
Mailing Address - City:WATERTOWN
Mailing Address - State:NY
Mailing Address - Zip Code:13601
Mailing Address - Country:US
Mailing Address - Phone:315-788-7070
Mailing Address - Fax:315-788-6927
Practice Address - Street 1:19333 US RT 11 OUTER WASHINGTON STREET
Practice Address - Street 2:
Practice Address - City:WATERTOWN
Practice Address - State:NY
Practice Address - Zip Code:13601
Practice Address - Country:US
Practice Address - Phone:315-788-7070
Practice Address - Fax:315-788-6927
Is Sole Proprietor?:No
Enumeration Date:2007-01-04
Last Update Date:2014-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY047150122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYVAD000Medicare UPIN