Provider Demographics
NPI:1215755756
Name:DR TREY MILLER, DDS MOORESVILLE PLLC
Entity type:Organization
Organization Name:DR TREY MILLER, DDS MOORESVILLE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:TREY
Authorized Official - Middle Name:
Authorized Official - Last Name:MILLER
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:704-456-9611
Mailing Address - Street 1:4291 SCHOOL HOUSE CMNS
Mailing Address - Street 2:
Mailing Address - City:HARRISBURG
Mailing Address - State:NC
Mailing Address - Zip Code:28075-7503
Mailing Address - Country:US
Mailing Address - Phone:704-456-9611
Mailing Address - Fax:980-825-6311
Practice Address - Street 1:4291 SCHOOL HOUSE CMNS
Practice Address - Street 2:
Practice Address - City:HARRISBURG
Practice Address - State:NC
Practice Address - Zip Code:28075-7503
Practice Address - Country:US
Practice Address - Phone:704-456-9611
Practice Address - Fax:980-825-6311
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:DR TREY MILLER, DDS PLLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-10-02
Last Update Date:2024-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental