Provider Demographics
NPI:1114775004
Name:JOSHUA D MILLER DMD PLLC
Entity type:Organization
Organization Name:JOSHUA D MILLER DMD PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:APRIL
Authorized Official - Middle Name:
Authorized Official - Last Name:PALACIO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:980-819-8981
Mailing Address - Street 1:11940 CAROLINA PLACE PKWY STE 103
Mailing Address - Street 2:
Mailing Address - City:PINEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28134-7473
Mailing Address - Country:US
Mailing Address - Phone:980-819-8981
Mailing Address - Fax:
Practice Address - Street 1:11940 CAROLINA PLACE PKWY STE 103
Practice Address - Street 2:
Practice Address - City:PINEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28134-7473
Practice Address - Country:US
Practice Address - Phone:980-819-8981
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-05-07
Last Update Date:2024-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty