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General NPI Number Information
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NPI Number | 1144877572
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Entity Type | Individual
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Provider Name | KRISTEN CAMILLE MILLENDER DDS
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Gender | Female
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Dates
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Enumeration Date | 08/21/2019
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Last Update Date | 08/21/2019
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Provider Practice Location Address
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Address Line | 3320 SAINT LUKES LN
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City | GWYNN OAK
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State | MD
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Zip | 21207-5836
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Country | US
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Telephone | 305-713-7796
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Fax |
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Provider Business Mailing Address
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Address Line | 7903 ORION CIR UNIT 379
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City | LAUREL
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State | MD
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Zip | 20724-3113
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Country | US
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Telephone | 305-713-7796
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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 | 16979
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License Number State | MD
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