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General NPI Number Information
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NPI Number | 1881016491
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Entity Type | Organization
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Legal Business Name | MILLER ORTHODONTICS, LLC
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Dates
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Enumeration Date | 01/16/2014
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Last Update Date | 09/09/2014
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Provider Practice Location Address
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Address Line | 2431 W MAIN ST SUITE 303
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City | DOTHAN
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State | AL
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Zip | 36301-1217
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Country | US
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Telephone | 334-446-0428
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Fax |
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Provider Business Mailing Address
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Address Line | 2431 W MAIN ST SUITE 303
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City | DOTHAN
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State | AL
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Zip | 36301-1217
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Country | US
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Telephone | 334-446-0428
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. KATHERINE B MILLER
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Credential | D.M.D., M.S.
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Telephone | 334-446-0428
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | 5597
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License Number State | AL
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