MEDICARE: DR. ELIZABETH CASTLEBERRY MILLER DDS

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	36067	TX

General Provider Information

NPI Number	:	1033751318
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ELIZABETH CASTLEBERRY MILLER DDS

Provider Business Mailing Address
First Line	:	1120 15TH ST # GC1340
Second Line	:
City	:	AUGUSTA
State	:	GA
Zip	:	30912-5490
Country	:	US
Telephone Number	:	512-492-5540
Fax Number	:

Provider Business Practice Location Address
First Line	:	1430 JOHN WESLEY GILBERT DRIVE
Second Line	:
City	:	AUGUSTA
State	:	GA
Zip	:	30912-3923
Country	:	US
Telephone Number	:	706-721-2441
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/08/2019
Last Update Date	:	03/07/2023

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Directions to “ DR. ELIZABETH CASTLEBERRY MILLER DDS” Practice Location

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