=====================================================
General NPI Number Information
=====================================================
NPI Number | 1841510351
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | CYNTHIA MILLER, DDS
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/07/2010
-----------------------------------------------------
Last Update Date | 06/07/2010
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 6 PARK CENTER CT SUITE 107
-----------------------------------------------------
City | OWINGS MILLS
-----------------------------------------------------
State | MD
-----------------------------------------------------
Zip | 21117-5601
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 410-363-2269
-----------------------------------------------------
Fax | 410-363-3995
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 6 PARK CENTER CT SUITE 107
-----------------------------------------------------
City | OWINGS MILLS
-----------------------------------------------------
State | MD
-----------------------------------------------------
Zip | 21117-5601
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 410-363-2269
-----------------------------------------------------
Fax | 410-363-3995
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | DR. CYNTHIA F MILLER
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 410-363-2269
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 1223P0700X
-----------------------------------------------------
Taxonomy Name | Prosthodontics
-----------------------------------------------------
License Number | 5369
-----------------------------------------------------
License Number State | MD
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 1223G0001X
-----------------------------------------------------
Taxonomy Name | General Practice Dentistry
-----------------------------------------------------
License Number | 8353
-----------------------------------------------------
License Number State | MD
-----------------------------------------------------