Provider Demographics
NPI:1801886387
Name:MILLER, CYNTHIA (DMD)
Entity type:Individual
Prefix:DR
First Name:CYNTHIA
Middle Name:
Last Name:MILLER
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1005 TREASURE LK
Mailing Address - Street 2:
Mailing Address - City:DU BOIS
Mailing Address - State:PA
Mailing Address - Zip Code:15801-9024
Mailing Address - Country:US
Mailing Address - Phone:814-372-2377
Mailing Address - Fax:
Practice Address - Street 1:816 STATE ST
Practice Address - Street 2:
Practice Address - City:CURWENSVILLE
Practice Address - State:PA
Practice Address - Zip Code:16833-1039
Practice Address - Country:US
Practice Address - Phone:814-236-0539
Practice Address - Fax:814-236-0443
Is Sole Proprietor?:No
Enumeration Date:2005-10-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS0313057L122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0018263730001Medicaid