Provider Demographics
NPI:1194338954
Name:MILLER, CHLOE MARIE (DDS)
Entity type:Individual
Prefix:
First Name:CHLOE
Middle Name:MARIE
Last Name:MILLER
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:CHLOE
Other - Middle Name:MARIE
Other - Last Name:MIRICK
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DDS
Mailing Address - Street 1:22820 96TH PL S
Mailing Address - Street 2:
Mailing Address - City:KENT
Mailing Address - State:WA
Mailing Address - Zip Code:98031-2984
Mailing Address - Country:US
Mailing Address - Phone:206-200-7337
Mailing Address - Fax:
Practice Address - Street 1:31003 PACIFIC HWY S
Practice Address - Street 2:
Practice Address - City:FEDERAL WAY
Practice Address - State:WA
Practice Address - Zip Code:98003-4903
Practice Address - Country:US
Practice Address - Phone:206-200-7337
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-30
Last Update Date:2020-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADE61090946122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist