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Individual

MARIANNE D MILLER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
2050 TILDEN AVE, BOX 1000, NEW HARTFORD, NY 13413-3613
(315) 797-3114
(315) 624-0474
Mailing address
2050 TILDEN AVE, BOX 1000, NEW HARTFORD, NY 13413-3613
(315) 797-3114
(315) 624-0474

Taxonomy

Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
023915
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00474180
NY
05
334526
NY
05
335475
NY
Enumeration date
12/10/2008
Last updated
06/22/2012
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