Provider Demographics
NPI:1386420867
Name:RICHARD J. MILLER, DMD & ASSOCIATES, LLC
Entity type:Organization
Organization Name:RICHARD J. MILLER, DMD & ASSOCIATES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER / DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:J
Authorized Official - Last Name:MILLER
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:814-355-1587
Mailing Address - Street 1:115 S SCHOOL ST
Mailing Address - Street 2:
Mailing Address - City:BELLEFONTE
Mailing Address - State:PA
Mailing Address - Zip Code:16823-2322
Mailing Address - Country:US
Mailing Address - Phone:814-355-1587
Mailing Address - Fax:814-355-2179
Practice Address - Street 1:115 S SCHOOL ST
Practice Address - Street 2:
Practice Address - City:BELLEFONTE
Practice Address - State:PA
Practice Address - Zip Code:16823-2322
Practice Address - Country:US
Practice Address - Phone:814-355-1587
Practice Address - Fax:814-355-2179
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:RICHARD J. MILLER, DMD & ASSOCIATES, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-08-31
Last Update Date:2024-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1942627690Medicaid