Provider Demographics
NPI:1336868561
Name:DR MICHAEL J. MILLER, D.D.S.
Entity Type:Organization
Organization Name:DR MICHAEL J. MILLER, D.D.S.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:MEGHAN
Authorized Official - Middle Name:N
Authorized Official - Last Name:MCCAULEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:304-698-7271
Mailing Address - Street 1:86 E MAIN ST STE A
Mailing Address - Street 2:
Mailing Address - City:BUCKHANNON
Mailing Address - State:WV
Mailing Address - Zip Code:26201-2733
Mailing Address - Country:US
Mailing Address - Phone:304-472-8598
Mailing Address - Fax:304-472-0651
Practice Address - Street 1:86 E MAIN ST STE A
Practice Address - Street 2:
Practice Address - City:BUCKHANNON
Practice Address - State:WV
Practice Address - Zip Code:26201-2733
Practice Address - Country:US
Practice Address - Phone:304-472-8598
Practice Address - Fax:304-472-0651
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-08-23
Last Update Date:2022-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental