Provider Demographics
NPI:1386356863
Name:KATELYN C MILLER DDS LLC
Entity type:Organization
Organization Name:KATELYN C MILLER DDS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:KATELYN
Authorized Official - Middle Name:
Authorized Official - Last Name:MILLER
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:740-936-3083
Mailing Address - Street 1:120 N MILLER DR STE A
Mailing Address - Street 2:
Mailing Address - City:SUNBURY
Mailing Address - State:OH
Mailing Address - Zip Code:43074-7651
Mailing Address - Country:US
Mailing Address - Phone:740-936-3083
Mailing Address - Fax:740-936-3683
Practice Address - Street 1:120 N MILLER DR STE A
Practice Address - Street 2:
Practice Address - City:SUNBURY
Practice Address - State:OH
Practice Address - Zip Code:43074-7651
Practice Address - Country:US
Practice Address - Phone:740-936-3083
Practice Address - Fax:740-936-3683
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-12-16
Last Update Date:2023-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty
No332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized EquipmentGroup - Multi-Specialty