Donald T. Miller Jr., D.M.D.
Individual provider Active NPI General Practice Dentistry · Genoa, IL
NPI 1538273198 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1538273198
- Entity type
- Individual (NPI type 1)
- Primary specialty
- General Practice Dentistry 1223G0001X
- Practice address
- 619 E Main St
Genoa, IL 60135-1309 - Phone
- (815) 784-5166
- Fax
- (815) 784-5167
- NPI assigned
- Aug 19, 2006
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 019-017769 | IL | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| David N McAuslan DDS PC | Past | Accepting new patients | |
| Justin T. Durancik, DDS, PLLC | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | IL | Yes |
Addresses
Primary practice location
619 E Main St
Genoa, IL 60135-1309
Mailing address
619 E Main St
Genoa, IL 60135-1309
Phone (815) 784-5166
Other providers in Genoa, IL
- L Doyle Inc
- Jill Lang
- Julie Renee Long
- Martine Lyle
- Julie Mensching
- Angela Moore
- Natural Family Health S.C.
- Northern Rehabilitation and Sports Medicine Associates
- Patricia Maria Pasillas Cardenas
- Sherie Anne Perdue
All providers in Genoa, IL · General Practice Dentistry in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.