Provider Demographics
NPI:1700276318
Name:CHAD J. MILLER DDS PA
Entity Type:Organization
Organization Name:CHAD J. MILLER DDS PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CHAD
Authorized Official - Middle Name:J
Authorized Official - Last Name:MILLER
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:336-431-9571
Mailing Address - Street 1:3203 ARCHDALE RD
Mailing Address - Street 2:
Mailing Address - City:ARCHDALE
Mailing Address - State:NC
Mailing Address - Zip Code:27263-2709
Mailing Address - Country:US
Mailing Address - Phone:336-431-9571
Mailing Address - Fax:336-431-5691
Practice Address - Street 1:3203 ARCHDALE RD
Practice Address - Street 2:
Practice Address - City:ARCHDALE
Practice Address - State:NC
Practice Address - Zip Code:27263-2709
Practice Address - Country:US
Practice Address - Phone:336-431-9571
Practice Address - Fax:336-431-5691
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-02-03
Last Update Date:2015-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty