Provider Demographics
NPI:1487713939
Name:MILLER, RICK W (DDS)
Entity type:Individual
Prefix:
First Name:RICK
Middle Name:W
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 1:4536 BILTMOORE DR
Mailing Address - Street 2:
Mailing Address - City:FRISCO
Mailing Address - State:TX
Mailing Address - Zip Code:75034-6861
Mailing Address - Country:US
Mailing Address - Phone:972-624-6249
Mailing Address - Fax:
Practice Address - Street 1:4222 TRINITY MILLS RD STE 118
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75287-7658
Practice Address - Country:US
Practice Address - Phone:972-380-2118
Practice Address - Fax:972-380-1936
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX148781223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX14878OtherGENERAL DENTISTRY