Healthcare Provider Details

I. General information

NPI: 1891048732
Provider Name (Legal Business Name): ELIZABETH C MIER DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/16/2012
Last Update Date: 03/17/2022
Certification Date: 03/17/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

40169 TRUCKEE AIRPORT RD STE 204
TRUCKEE CA
96161-4109
US

IV. Provider business mailing address

40169 TRUCKEE AIRPORT RD STE 204
TRUCKEE CA
96161-4109
US

V. Phone/Fax

Practice location:
  • Phone: 530-587-9095
  • Fax:
Mailing address:
  • Phone: 530-587-9095
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number61566
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: