Provider Demographics
NPI:1962590448
Name:MILLER, DANIEL S (DDS)
Entity type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:S
Last Name:MILLER
Suffix:
Gender:M
Credentials:DDS
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Mailing Address - Street 1:16168 BEACH BLVD
Mailing Address - Street 2:#100
Mailing Address - City:HUNTINGTON BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92647
Mailing Address - Country:US
Mailing Address - Phone:714-842-7729
Mailing Address - Fax:714-842-5968
Practice Address - Street 1:16168 BEACH BLVD
Practice Address - Street 2:#100
Practice Address - City:HUNTINGTON BEACH
Practice Address - State:CA
Practice Address - Zip Code:92647
Practice Address - Country:US
Practice Address - Phone:714-842-7729
Practice Address - Fax:714-842-5968
Is Sole Proprietor?:No
Enumeration Date:2006-10-10
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CA37875204E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes204E00000XAllopathic & Osteopathic PhysiciansOral & Maxillofacial Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
U65056Medicare UPIN