Provider Demographics
NPI:1700954591
Name:MILCH, ERIC A (DMD)
Entity Type:Individual
Prefix:DR
First Name:ERIC
Middle Name:A
Last Name:MILCH
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2305 EAST 52ND STREET
Mailing Address - Street 2:SUITE 1
Mailing Address - City:DAVENPORT
Mailing Address - State:IA
Mailing Address - Zip Code:52807
Mailing Address - Country:US
Mailing Address - Phone:563-355-9424
Mailing Address - Fax:563-355-0180
Practice Address - Street 1:2305 E 52ND ST
Practice Address - Street 2:SUITE 1
Practice Address - City:DAVENPORT
Practice Address - State:IA
Practice Address - Zip Code:52807
Practice Address - Country:US
Practice Address - Phone:563-355-9424
Practice Address - Fax:563-355-0180
Is Sole Proprietor?:No
Enumeration Date:2006-12-01
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA077661223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0097766Medicaid
IA0097766Medicaid
U51071Medicare UPIN
IA0097766Medicaid