MEDICARE: BRYCE R 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	16440	MD

General Provider Information

NPI Number	:	1528551975
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BRYCE R MILLER DDS

Provider Business Mailing Address
First Line	:	3905 NATIONAL DR STE 340
Second Line	:
City	:	BURTONSVILLE
State	:	MD
Zip	:	20866-6111
Country	:	US
Telephone Number	:	301-421-1300
Fax Number	:

Provider Business Practice Location Address
First Line	:	3905 NATIONAL DR STE 340
Second Line	:
City	:	BURTONSVILLE
State	:	MD
Zip	:	20866-6111
Country	:	US
Telephone Number	:	301-421-1300
Fax Number	:

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

Provider Enumeration Date	:	06/11/2018
Last Update Date	:	08/10/2023

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