Healthcare Provider Details

I. General information

NPI: 1205843455
Provider Name (Legal Business Name): BILL J MILLER DDS MS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/01/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2200 S FEDERAL BLVD
DENVER CO
80219-5444
US

IV. Provider business mailing address

2200 S FEDERAL BLVD
DENVER CO
80219-5444
US

V. Phone/Fax

Practice location:
  • Phone: 303-935-0815
  • Fax: 303-935-0815
Mailing address:
  • Phone: 303-935-0815
  • Fax: 303-935-0815

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223X0400X
TaxonomyOrthodontics and Dentofacial Orthopedics Dentistry
License Number3507
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: