Individual
DR. THEODORE SCOTT MCMILLIN
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
1754 COMMERCE CENTER BLVD, FAIRBORN, OH 45324-6358
(937) 878-1451
Mailing address
4553 FAIRFIELD PIKE, SPRINGFIELD, OH 45502-9705
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
018597
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
102680
SUPERIOR DENTAL
OH
01
—
588775
UNITED CONCORDIA
OH
Enumeration date
03/23/2006
Last updated
07/08/2007
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