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General NPI Number Information
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NPI Number | 1851744940
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Entity Type | Organization
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Legal Business Name | SUSAN S. MILLER, DDS. PLLC
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Dates
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Enumeration Date | 07/13/2016
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Last Update Date | 07/13/2016
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Provider Practice Location Address
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Address Line | 7750 15TH AVE NE SUITE A
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City | SEATTLE
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State | WA
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Zip | 98115-4313
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Country | US
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Telephone | 206-402-3402
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Fax | 206-402-3460
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Provider Business Mailing Address
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Address Line | 7750 15TH AVE NE SUITE A
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City | SEATTLE
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State | WA
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Zip | 98115-4313
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Country | US
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Telephone | 206-402-3402
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Fax | 206-402-3460
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Authorized Official
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Title or Position | OWNER
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Name | DR. SUSAN S MILLER
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Credential | DDS
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Telephone | 206-402-3402
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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 | DE00003086
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License Number State | WA
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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 | DE00006218
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License Number State | WA
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