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General NPI Number Information
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NPI Number | 1326198433
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Entity Type | Individual
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Provider Name | NICHOLE S MILLER DDS
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Gender | Female
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Dates
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Enumeration Date | 01/11/2007
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Last Update Date | 01/07/2016
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Provider Practice Location Address
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Address Line | 3290 RIDGEWAY DRIVE SUITE 4
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City | CORALVILLE
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State | IA
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Zip | 52241
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Country | US
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Telephone | 319-626-2119
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Fax | 319-626-2315
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Provider Business Mailing Address
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Address Line | 3290 RIDGEWAY DR STE 4
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City | CORALVILLE
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State | IA
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Zip | 52241-2023
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Country | US
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Telephone | 319-626-2119
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Fax | 319-626-2315
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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 | 7933
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License Number State | IA
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