Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223X0400X | Orthodontists | 12009579 | IN |
NPI | 1003913492 |
---|---|
Provider Name | Dr. Ronald L Miller |
First Address | Carmel, IN 46032-5802 |
Second Address | Carmel, IN 46032-5802 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 20/09/2006 |
Last Update Date | 31/07/2008 |