Provider Demographics
NPI:1649368879
Name:MCMILLAN, DOUGLAS WESLEY (DDS)
Entity type:Individual
Prefix:DR
First Name:DOUGLAS
Middle Name:WESLEY
Last Name:MCMILLAN
Suffix:
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 1:7839 OLD HARDING RD
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37221-3907
Mailing Address - Country:US
Mailing Address - Phone:615-673-6700
Mailing Address - Fax:615-673-6729
Practice Address - Street 1:7839 OLD HARDING RD
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37221-3907
Practice Address - Country:US
Practice Address - Phone:615-673-6700
Practice Address - Fax:615-673-6729
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN8058122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist