Albert Orville Miller III, DDS
Individual provider Active NPI General Practice Dentistry · Pendleton, IN
NPI 1720001522 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1720001522
- Entity type
- Individual (NPI type 1)
- Primary specialty
- General Practice Dentistry 1223G0001X
- License
- 12009676 (IN)
- Practice address
- 210 E Water St
Pendleton, IN 46064-1047 - Phone
- (765) 778-7558
- Fax
- (765) 778-7559
- NPI assigned
- Jul 25, 2006
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 12009676 | IN | MD | General Practice Dentistry |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 12009676 | IN | Yes |
Addresses
Primary practice location
210 E Water St
Pendleton, IN 46064-1047
Mailing address
210 E Water St
Pendleton, IN 46064-1047
Phone (765) 778-7558
Other providers in Pendleton, IN
- Kenzie Mauro
- Brittnee McCance
- Stacy McCarthy
- Michael Meng
- Dennis Joseph Meyer
- April Mitchell
- Brianna Moffett
- Rebecca M Morris
- MP Transportation LLC
- Moriah Eve Mroz
All providers in Pendleton, IN · General Practice Dentistry in Indiana
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.