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General NPI Number Information
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NPI Number | 1871892422
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Entity Type | Organization
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Legal Business Name | MILLER FAMILY DENTISTRY PLLC
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Dates
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Enumeration Date | 03/22/2011
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Last Update Date | 03/22/2011
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Provider Practice Location Address
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Address Line | 1204 E MAIN ST SUITE D
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City | WEATHERFORD
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State | OK
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Zip | 73096-5770
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Country | US
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Telephone | 580-772-5567
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 979
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City | WEATHERFORD
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State | OK
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Zip | 73096-0979
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER/DENTIST
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Name | DR. STEVEN BROCK MILLER
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Credential | D.D.S.
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Telephone | 405-248-3362
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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 |
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License Number State |
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