Provider Demographics
NPI:1255531950
Name:MILLAY, ROBERT JOSPEH (DMD)
Entity type:Individual
Prefix:
First Name:ROBERT
Middle Name:JOSPEH
Last Name:MILLAY
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:29 EURY LN
Mailing Address - Street 2:
Mailing Address - City:SOMERSET
Mailing Address - State:KY
Mailing Address - Zip Code:42501-4115
Mailing Address - Country:US
Mailing Address - Phone:606-802-2298
Mailing Address - Fax:606-678-8881
Practice Address - Street 1:29 EURY LN
Practice Address - Street 2:
Practice Address - City:SOMERSET
Practice Address - State:KY
Practice Address - Zip Code:42501-4115
Practice Address - Country:US
Practice Address - Phone:606-678-8881
Practice Address - Fax:606-678-8881
Is Sole Proprietor?:No
Enumeration Date:2007-07-20
Last Update Date:2013-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY83421223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY7100050540Medicaid