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General NPI Number Information
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NPI Number | 1205057718
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Entity Type | Individual
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Provider Name | DAVID J. MILLEA DDS
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Gender | Male
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Dates
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Enumeration Date | 05/01/2007
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Last Update Date | 08/21/2023
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Provider Practice Location Address
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Address Line | 2746 NO 63RD ST
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City | OMAHA
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State | NE
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Zip | 68104
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Country | US
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Telephone | 402-553-1042
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Fax | 402-553-1042
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Provider Business Mailing Address
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Address Line | PO BOX 4464 2746 NO 63RD ST
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City | OMAHA
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State | NE
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Zip | 68104
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Country | US
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Telephone | 402-553-1042
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Fax | 402-553-1042
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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 | 4582
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License Number State | NE
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