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General NPI Number Information
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NPI Number | 1114641354
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Entity Type | Individual
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Provider Name | ARIELLE MILLER
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Gender | Female
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Dates
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Enumeration Date | 09/30/2022
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Last Update Date | 09/30/2022
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Provider Practice Location Address
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Address Line | 7223 MISSISSIPPI AVE DENTAC, BLDG 1561
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City | FT POLK
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State | LA
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Zip | 71459
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Country | US
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Telephone | 337-531-2603
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Fax |
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Provider Business Mailing Address
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Address Line | 7223 MISSISSIPPI AVE DENTAC, BLDG 1561
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City | FT POLK
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State | LA
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Zip | 71459
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Country | US
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Telephone | 337-531-2603
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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 | 108186
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License Number State | CA
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