Provider Demographics
NPI:1255578472
Name:MILLER, KAREN ELAINE (DDS)
Entity type:Individual
Prefix:DR
First Name:KAREN
Middle Name:ELAINE
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 1:3401 MARKET STREET
Mailing Address - Street 2:SUITE 110 PENN DENTAL AT UNIVERSITY CITY
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19104-6228
Mailing Address - Country:US
Mailing Address - Phone:215-573-8400
Mailing Address - Fax:215-573-5550
Practice Address - Street 1:3401 MARKET STREET
Practice Address - Street 2:SUITE 110 PENN DENTAL AT UNIVERSITY CITY
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19104-6228
Practice Address - Country:US
Practice Address - Phone:215-573-8400
Practice Address - Fax:215-573-5550
Is Sole Proprietor?:No
Enumeration Date:2009-01-09
Last Update Date:2009-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS028062L1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice