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General NPI Number Information
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NPI Number | 1174415202
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Entity Type | Individual
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Provider Name | NOAH SPENSER MILES DMD
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Gender | Male
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Dates
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Enumeration Date | 07/15/2025
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Last Update Date | 07/15/2025
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Provider Practice Location Address
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Address Line | 1320 FAIRVIEW BLVD STE B
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City | DELRAN
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State | NJ
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Zip | 08075-2036
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Country | US
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Telephone | 856-764-2200
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Fax |
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Provider Business Mailing Address
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Address Line | 2006 BURROUGHS MILL CIR
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City | CHERRY HILL
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State | NJ
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Zip | 08002-1276
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Country | US
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Telephone | 302-668-5794
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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 | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 22DI03109600
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License Number State | NJ
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