MEDICARE: DR. LANCE SEWARD MILLER D.M.D

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	DS040461	PA

General Provider Information

NPI Number	:	1336523570
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LANCE SEWARD MILLER D.M.D

Provider Business Mailing Address
First Line	:	1824 FOX WAY REAR APT
Second Line	:
City	:	PITTSBURGH
State	:	PA
Zip	:	15203-1732
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1824 FOX WAY REAR APT
Second Line	:
City	:	PITTSBURGH
State	:	PA
Zip	:	15203-1732
Country	:	US
Telephone Number	:	717-448-7685
Fax Number	:

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

Provider Enumeration Date	:	07/17/2015
Last Update Date	:	07/17/2015

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