Organization
MAGNOLIA DENTAL CORPORATION PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RICHARDS RUDD MILLER DDS (PARTNER)
(540) 943-2723
Entity
Organization
Contact information
Practice address
400 SOUTH MAGNOLIA AVENUE, WAYNESBORO, VA 22980
(540) 943-2723
(540) 943-1419
Mailing address
400 SOUTH MAGNOLIA AVENUE, WAYNESBORO, VA 22980
(540) 943-2723
(540) 943-1419
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1354201
UNITED CONCORDIA
—
01
—
201253
ANTHEM
—
01
—
201256
ANTHEM
—
Enumeration date
10/16/2006
Last updated
08/22/2020
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