MEDICARE: DR. DEBORAH P. MILLIKEN D.M.D.

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	DN10469	FL

General Provider Information

NPI Number	:	1992047161
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DEBORAH P. MILLIKEN D.M.D.

Provider Business Mailing Address
First Line	:	600 W COLLEGE DR
Second Line	:	BLDG T-1
City	:	AVON PARK
State	:	FL
Zip	:	33825-9356
Country	:	US
Telephone Number	:	863-784-7023
Fax Number	:	863-784-7026

Provider Business Practice Location Address
First Line	:	600 W COLLEGE DR
Second Line	:	BLDG T-1
City	:	AVON PARK
State	:	FL
Zip	:	33825-9356
Country	:	US
Telephone Number	:	863-784-7023
Fax Number	:	863-784-7026

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

Provider Enumeration Date	:	03/26/2013
Last Update Date	:	03/26/2013

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