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General NPI Number Information
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NPI Number | 1023219060
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Entity Type | Individual
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Provider Name | BRIAN H. MILLER DDS
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Gender | Male
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Dates
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Enumeration Date | 05/29/2007
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Last Update Date | 07/09/2007
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Provider Practice Location Address
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Address Line | 801 MAIN ST
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City | CONCORD
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State | MA
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Zip | 01742-3313
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Country | US
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Telephone | 978-369-4709
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Fax |
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Provider Business Mailing Address
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Address Line | 23 LOCKE RD
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City | WABAN
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State | MA
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Zip | 02468-1415
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Country | US
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Telephone | 617-969-2779
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | 12230
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License Number State | MA
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