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General NPI Number Information
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NPI Number | 1336554864
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Entity Type | Individual
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Provider Name | MITCHELL MILLER DDS
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Gender | Male
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Dates
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Enumeration Date | 06/23/2014
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Last Update Date | 01/12/2021
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Provider Practice Location Address
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Address Line | 391 N CONGRESS AVE
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City | BOYNTON BEACH
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State | FL
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Zip | 33426-3415
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Country | US
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Telephone | 561-336-6560
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Fax | 561-336-6560
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Provider Business Mailing Address
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Address Line | 391 N CONGRESS AVE
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City | BOYNTON BEACH
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State | FL
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Zip | 33426-3415
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Country | US
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Telephone | 561-336-6560
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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 | DN21113
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number | DN21113
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License Number State | FL
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