Provider Demographics
NPI:1205889441
Name:MILLER, CARYN FERN (DMD)
Entity type:Individual
Prefix:DR
First Name:CARYN
Middle Name:FERN
Last Name:MILLER
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:CHATHAM
Mailing Address - State:NJ
Mailing Address - Zip Code:07928-2413
Mailing Address - Country:US
Mailing Address - Phone:973-635-4960
Mailing Address - Fax:973-701-1686
Practice Address - Street 1:300 MAIN ST
Practice Address - Street 2:
Practice Address - City:CHATHAM
Practice Address - State:NJ
Practice Address - Zip Code:07928-2413
Practice Address - Country:US
Practice Address - Phone:973-635-4960
Practice Address - Fax:973-701-1686
Is Sole Proprietor?:No
Enumeration Date:2006-05-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJDI151741223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics