Healthcare Provider Details

I. General information

NPI: 1740374420
Provider Name (Legal Business Name): JEFFREY T MILTON DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/03/2006
Last Update Date: 09/28/2022
Certification Date: 09/26/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

525 LIBERTY RD. N
POWELL OH
43065
US

IV. Provider business mailing address

525 LIBERTY RD. N
POWELL OH
43065
US

V. Phone/Fax

Practice location:
  • Phone: 614-433-7474
  • Fax: 614-433-9090
Mailing address:
  • Phone: 614-226-2697
  • Fax: 614-722-5671

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0221X
TaxonomyPediatric Dentistry
License Number30021874
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: