Healthcare Provider Details

I. General information

NPI: 1912861543
Provider Name (Legal Business Name): DANIEL G. MILLER, DDS, FAGD, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/09/2025
Last Update Date: 12/09/2025
Certification Date: 12/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

22 S PEARSALL LANE UNIT B
HAMPSTEAD NC
28443
US

IV. Provider business mailing address

22 S PEARSALL LANE UNIT B
HAMPSTEAD NC
28443
US

V. Phone/Fax

Practice location:
  • Phone: 910-406-0787
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QD0000X
TaxonomyDental Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. DANIEL MILLER
Title or Position: DENTIST
Credential: DDS
Phone: 910-406-0787