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NPI Code Detail

MEDICARE: DR. J. BRAD MILLER DDS

MEDICARE: DR. J. BRAD 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
11223G0001XGeneral Practice Dentistry7993IA

General Provider Information

NPI Number : 1609929264
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. J. BRAD MILLER DDS
Provider Business Mailing Address
First Line : 701 WASHINGTON AVE
Second Line :
City : IOWA FALLS
State : IA
Zip : 50126-2100
Country : US
Telephone Number : 641-648-4293
Fax Number : 641-648-3784
Provider Business Practice Location Address
First Line : 701 WASHINGTON AVE
Second Line :
City : IOWA FALLS
State : IA
Zip : 50126-2100
Country : US
Telephone Number : 641-648-4293
Fax Number : 641-648-3784
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/18/2007
Last Update Date : 11/10/2022

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