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General NPI Number Information
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NPI Number | 1447980057
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Entity Type | Individual
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Provider Name | ZACK ALEXANDER MILLER DDS
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Gender | Male
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Dates
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Enumeration Date | 06/15/2022
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Last Update Date | 04/15/2025
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Provider Practice Location Address
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Address Line | 1303 W FLETCHER AVE
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City | TAMPA
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State | FL
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Zip | 33612-3310
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Country | US
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Telephone | 813-427-2237
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Fax |
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Provider Business Mailing Address
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Address Line | 275 44TH AVE
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City | ST PETE BEACH
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State | FL
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Zip | 33706-2516
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Country | US
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Telephone |
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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 | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | DN26906
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License Number State | FL
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