MEDICARE: TRAVIS L. MUELLER, DDS, PC

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	1223G0001X	General Practice Dentistry	M00159001	VA

General Provider Information

NPI Number	:	1689032641
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TRAVIS L. MUELLER, DDS, PC

Provider Business Mailing Address
First Line	:	3424 LAUDERDALE DR
Second Line	:
City	:	RICHMOND
State	:	VA
Zip	:	23233-7528
Country	:	US
Telephone Number	:	804-360-1800
Fax Number	:	804-335-1297

Provider Business Practice Location Address
First Line	:	3424 LAUDERDALE DR
Second Line	:
City	:	RICHMOND
State	:	VA
Zip	:	23233-7528
Country	:	US
Telephone Number	:	804-360-1800
Fax Number	:	804-335-1297

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. TRAVIS LEE MUELLER
Credential	:	DDS
Telephone Number	:	804-360-1800

Provider Enumeration Date	:	02/05/2016
Last Update Date	:	02/05/2016

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