MEDICARE: JOHN A. MILLER, DMD, LLC

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	2942	SC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1801019344
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JOHN A. MILLER, DMD, LLC

Provider Business Mailing Address
First Line	:	1209 N FRASER ST
Second Line	:
City	:	GEORGETOWN
State	:	SC
Zip	:	29440-2853
Country	:	US
Telephone Number	:	843-546-2273
Fax Number	:	843-546-7777

Provider Business Practice Location Address
First Line	:	1209 N FRASER ST
Second Line	:
City	:	GEORGETOWN
State	:	SC
Zip	:	29440-2853
Country	:	US
Telephone Number	:	843-546-2273
Fax Number	:	843-546-7777

Authorized Official
Title or Position	:	PROPRIETOR
Name	:	DR. JOHN A. MILLER
Credential	:	DMD
Telephone Number	:	843-546-2273

Provider Enumeration Date	:	04/11/2007
Last Update Date	:	08/22/2020

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