Healthcare Provider Details

I. General information

NPI: 1841510351
Provider Name (Legal Business Name): CYNTHIA MILLER, DDS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/07/2010
Last Update Date: 06/07/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6 PARK CENTER CT SUITE 107
OWINGS MILLS MD
21117-5601
US

IV. Provider business mailing address

6 PARK CENTER CT SUITE 107
OWINGS MILLS MD
21117-5601
US

V. Phone/Fax

Practice location:
  • Phone: 410-363-2269
  • Fax: 410-363-3995
Mailing address:
  • Phone: 410-363-2269
  • Fax: 410-363-3995

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number8353
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code1223P0700X
TaxonomyProsthodontics
License Number5369
License Number StateMD

VIII. Authorized Official

Name: DR. CYNTHIA F MILLER
Title or Position: OWNER
Credential:
Phone: 410-363-2269