Provider Demographics
NPI:1255709630
Name:MILLER, KATHERINE LENORE (DDS)
Entity type:Individual
Prefix:DR
First Name:KATHERINE
Middle Name:LENORE
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 1:1003 TOWAMENCIN AVE
Mailing Address - Street 2:APT E302
Mailing Address - City:LANSDALE
Mailing Address - State:PA
Mailing Address - Zip Code:19446-5653
Mailing Address - Country:US
Mailing Address - Phone:301-758-4892
Mailing Address - Fax:
Practice Address - Street 1:1003 TOWAMENCIN AVE
Practice Address - Street 2:APT E302
Practice Address - City:LANSDALE
Practice Address - State:PA
Practice Address - Zip Code:19446-5653
Practice Address - Country:US
Practice Address - Phone:301-758-4892
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-09-02
Last Update Date:2015-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS040556122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist