Organization
RANDALL L MILLER DDS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RANDALL LEE MILLER DDS (OWNER/DENTIST)
(317) 398-2103
Entity
Organization
Contact information
Practice address
117 W WASHINGTON ST, SHELBYVILLE, IN 46176-1245
(317) 398-2103
(317) 421-1570
Mailing address
117 W WASHINGTON ST, SHELBYVILLE, IN 46176-1245
(317) 398-2103
(317) 421-1570
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
12009483A
IN
122300000X
Dentist
12010992A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100224820A
—
IN
Enumeration date
04/03/2014
Last updated
04/03/2014
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