MEDICARE: DONNA G MILLER DDS PA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	122300000X	Dentist	14668	TX

General Provider Information

NPI Number	:	1013913375
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DONNA G MILLER DDS PA

Provider Business Mailing Address
First Line	:	7911 WOODWAY DRIVE
Second Line	:
City	:	WACO
State	:	TX
Zip	:	76712-3866
Country	:	US
Telephone Number	:	254-772-3632
Fax Number	:	254-772-7856

Provider Business Practice Location Address
First Line	:	7911 WOODWAY DRIVE
Second Line	:
City	:	WACO
State	:	TX
Zip	:	76712
Country	:	US
Telephone Number	:	254-772-3632
Fax Number	:	254-772-7856

Authorized Official
Title or Position	:	OWNER
Name	:	DR. DONNA G MILLER
Credential	:	D.D.S
Telephone Number	:	254-772-3632

Provider Enumeration Date	:	06/22/2005
Last Update Date	:	06/27/2018

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