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General NPI Number Information
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NPI Number | 1821172594
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Entity Type | Individual
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Provider Name | WAYNE RUSSELL MILLAR D.D.S.
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Gender | Male
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Dates
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Enumeration Date | 10/25/2006
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Last Update Date | 10/22/2024
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Provider Practice Location Address
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Address Line | 25 KANEOHE BAY DR STE 102
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City | KAILUA
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State | HI
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Zip | 96734-1711
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Country | US
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Telephone | 808-254-2124
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Fax | 808-254-2464
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Provider Business Mailing Address
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Address Line | 25 KANEOHE BAY DR STE 102
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City | KAILUA
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State | HI
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Zip | 96734-1711
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Country | US
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Telephone | 808-254-2124
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Fax | 808-254-2464
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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 | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 35002
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 1790
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License Number State | HI
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Taxonomy #3
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 9681
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License Number State | MD
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