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NPI Code Detail

MEDICARE: J. BRADLEY MILLER DDS

MEDICARE: J. BRADLEY MILLER DDS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11223G0001XGeneral Practice Dentistry05971IA
21223G0001XGeneral Practice Dentistry07993IA

General Provider Information

NPI Number : 1275787426
Entity Type Code : Organization
Provider Name (Legal Business Name) : J. BRADLEY MILLER DDS
Provider Business Mailing Address
First Line : 701 WASHINGTON AVE
Second Line :
City : IOWA FALLS
State : IA
Zip : 50126-2100
Country : US
Telephone Number : 641-648-4293
Fax Number : 641-648-3784
Provider Business Practice Location Address
First Line : 701 WASHINGTON AVE
Second Line :
City : IOWA FALLS
State : IA
Zip : 50126-2100
Country : US
Telephone Number : 641-648-4293
Fax Number : 641-648-3784
Authorized Official
Title or Position : OWNER/DENTIST
Name : DR. J. BRAD MILLER
Credential : DDS
Telephone Number : 641-648-4293
Provider Enumeration Date : 11/13/2008
Last Update Date : 07/28/2010

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