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General NPI Number Information
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NPI Number | 1447115423
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Entity Type | Organization
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Legal Business Name | PALM BEACH PEDIATRIC DENTISTRY AND ORTHODONTICS, PLLC
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Dates
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Enumeration Date | 12/22/2025
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Last Update Date | 12/22/2025
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Provider Practice Location Address
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Address Line | 5405 OKEECHOBEE BLVD STE 205
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City | WEST PALM BEACH
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State | FL
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Zip | 33417-4544
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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 | 5405 OKEECHOBEE BLVD STE 205
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City | WEST PALM BEACH
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State | FL
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Zip | 33417-4544
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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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Authorized Official
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Title or Position | MEMBER
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Name | MITCHELL MILLER
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Credential | DDS
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Telephone | 561-336-6560
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number |
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License Number State |
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