MEDICARE: DR. SCOTT LEWIS 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	1223G0001X	General Practice Dentistry	2487	CA

General Provider Information

NPI Number	:	1811917453
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SCOTT LEWIS MILLER DDS

Provider Business Mailing Address
First Line	:	7480 W SAHARA AVE
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89117-2740
Country	:	US
Telephone Number	:	702-562-2033
Fax Number	:	702-562-0455

Provider Business Practice Location Address
First Line	:	7480 W SAHARA AVE
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89117-2740
Country	:	US
Telephone Number	:	702-562-2033
Fax Number	:	702-562-0455

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

Provider Enumeration Date	:	07/19/2006
Last Update Date	:	07/08/2007

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