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General NPI Number Information
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NPI Number | 1841555687
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Entity Type | Individual
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Provider Name | KATELYN C MILLER D.D.S.
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Gender | Female
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Dates
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Enumeration Date | 07/09/2012
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Last Update Date | 12/05/2023
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Provider Practice Location Address
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Address Line | 1344 LANCASTER AVE
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City | REYNOLDSBURG
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State | OH
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Zip | 43068-2136
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Country | US
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Telephone | 614-863-6205
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Fax |
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Provider Business Mailing Address
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Address Line | 120 N MILLER DR STE A
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City | SUNBURY
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State | OH
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Zip | 43074-7651
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Country | US
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Telephone | 409-363-0837
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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 | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 30-023751
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License Number State | OH
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