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General NPI Number Information
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NPI Number | 1851963573
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Entity Type | Individual
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Provider Name | ANDREA NICOLE MILLER DMD
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Gender | Female
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Dates
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Enumeration Date | 07/13/2021
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Last Update Date | 07/13/2021
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Provider Practice Location Address
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Address Line | 1209 N RETAIL CT
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City | MYRTLE BEACH
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State | SC
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Zip | 29577-9626
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Country | US
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Telephone | 843-874-4060
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Fax |
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Provider Business Mailing Address
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Address Line | 1383 HADLEY CIR # B-2201
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City | MYRTLE BEACH
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State | SC
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Zip | 29577-8208
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Country | US
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Telephone | 814-528-8546
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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 | 9993
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License Number State | SC
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