Provider Demographics
NPI:1255525440
Name:MILLER, ERNEST PATRICK JR (DDS)
Entity type:Individual
Prefix:DR
First Name:ERNEST
Middle Name:PATRICK
Last Name:MILLER
Suffix:JR
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 1:5138 UTSA BLVD STE 116
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78249-3537
Mailing Address - Country:US
Mailing Address - Phone:210-699-9761
Mailing Address - Fax:
Practice Address - Street 1:5138 UTSA BLVD STE 116
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78249-3537
Practice Address - Country:US
Practice Address - Phone:210-699-9761
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-30
Last Update Date:2018-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX234391223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice