Provider Demographics
NPI:1215074141
Name:MILLER, ALLAN MARK (DDS)
Entity type:Individual
Prefix:DR
First Name:ALLAN
Middle Name:MARK
Last Name:MILLER
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:540 N STATE RD
Mailing Address - Street 2:
Mailing Address - City:BRIARCLIFF MANOR
Mailing Address - State:NY
Mailing Address - Zip Code:10510-1598
Mailing Address - Country:US
Mailing Address - Phone:914-941-1639
Mailing Address - Fax:914-941-0732
Practice Address - Street 1:540 N STATE RD
Practice Address - Street 2:
Practice Address - City:BRIARCLIFF MANOR
Practice Address - State:NY
Practice Address - Zip Code:10510-1598
Practice Address - Country:US
Practice Address - Phone:914-941-1639
Practice Address - Fax:914-941-0732
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0330941223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice