Healthcare Provider Details

I. General information

NPI: 1750771234
Provider Name (Legal Business Name): EMILY MILLER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/04/2015
Last Update Date: 02/04/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

125 E 8TH AVE
EUGENE OR
97401-2926
US

IV. Provider business mailing address

924 PRESCOTT LN
SPRINGFIELD OR
97477-3628
US

V. Phone/Fax

Practice location:
  • Phone: 541-682-3560
  • Fax:
Mailing address:
  • Phone: 541-232-2368
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code124Q00000X
TaxonomyDental Hygienist
License NumberH5119
License Number StateOR

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: