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General NPI Number Information
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NPI Number | 1083846554
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Entity Type | Individual
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Provider Name | ASHLEY MILLER D.D.S.
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Gender | Female
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Dates
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Enumeration Date | 08/18/2009
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Last Update Date | 12/04/2019
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Provider Practice Location Address
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Address Line | 1153 N LIBERTY ST
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City | NICHOLLS
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State | GA
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Zip | 31554
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Country | US
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Telephone | 912-345-5058
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Fax |
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Provider Business Mailing Address
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Address Line | 290 BAYMEADOWS DR W
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City | DOUGLAS
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State | GA
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Zip | 31535-6702
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Country | US
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Telephone | 734-834-7848
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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 | 122300000X
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Taxonomy Name | Dentist
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License Number | DN015301
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 9954
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License Number State | CO
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