Provider Demographics
NPI:1972716504
Name:MILLER, CHRISTOPHER R (DDS)
Entity type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:R
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 1:33143 US HIGHWAY 19 N
Mailing Address - Street 2:
Mailing Address - City:PALM HARBOR
Mailing Address - State:FL
Mailing Address - Zip Code:34684-3126
Mailing Address - Country:US
Mailing Address - Phone:727-785-8273
Mailing Address - Fax:727-787-7033
Practice Address - Street 1:33143 US HIGHWAY 19 N
Practice Address - Street 2:
Practice Address - City:PALM HARBOR
Practice Address - State:FL
Practice Address - Zip Code:34684-3126
Practice Address - Country:US
Practice Address - Phone:727-785-8273
Practice Address - Fax:727-787-7033
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN82261223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice