MEDICARE: ANDREW S. MILLER 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	1223G0001X	CO

General Provider Information

NPI Number	:	1760645717
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ANDREW S. MILLER DDS,PC

Provider Business Mailing Address
First Line	:	1714 N CIRCLE DR
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80909-2409
Country	:	US
Telephone Number	:	719-632-6001
Fax Number	:

Provider Business Practice Location Address
First Line	:	1714 N CIRCLE DR
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80909-2409
Country	:	US
Telephone Number	:	719-632-6001
Fax Number	:

Authorized Official
Title or Position	:	DENTIST
Name	:	DR. ANDREW SCOTT MILLER
Credential	:
Telephone Number	:	719-632-6001

Provider Enumeration Date	:	07/09/2008
Last Update Date	:	07/09/2008

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