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General NPI Number Information
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NPI Number | 1619596590
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Entity Type | Individual
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Provider Name | TREVOR EDWARD MILLER DDS
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Gender | Male
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Dates
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Enumeration Date | 04/10/2020
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Last Update Date | 09/14/2023
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Provider Practice Location Address
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Address Line | 311 BLANDING BLVD STE 7
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City | ORANGE PARK
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State | FL
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Zip | 32073-4363
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Country | US
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Telephone | 904-404-2444
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Fax |
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Provider Business Mailing Address
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Address Line | 5883 HYDE PARK CIR
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City | JACKSONVILLE
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State | FL
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Zip | 32210-1311
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Country | US
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Telephone | 248-872-5376
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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 | DN122506
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | D6950-C1
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License Number State | AL
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Taxonomy #3
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | DN26497
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License Number State | FL
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