Provider Demographics
NPI:1841299757
Name:MILLER, NOAH DEAN (DMD,LLC)
Entity type:Individual
Prefix:DR
First Name:NOAH
Middle Name:DEAN
Last Name:MILLER
Suffix:
Gender:M
Credentials:DMD,LLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2729 RAINBOW DR
Mailing Address - Street 2:
Mailing Address - City:RAINBOW CITY
Mailing Address - State:AL
Mailing Address - Zip Code:35906-5815
Mailing Address - Country:US
Mailing Address - Phone:256-442-8081
Mailing Address - Fax:256-442-8082
Practice Address - Street 1:2729 RAINBOW DR
Practice Address - Street 2:
Practice Address - City:RAINBOW CITY
Practice Address - State:AL
Practice Address - Zip Code:35906-5815
Practice Address - Country:US
Practice Address - Phone:256-442-8081
Practice Address - Fax:256-442-8082
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-21
Last Update Date:2007-07-08
Deactivation Date:2006-03-20
Deactivation Code:
Reactivation Date:2006-03-24
Provider Licenses
StateLicense IDTaxonomies
AL34441223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice