| Randall L Miller Dds Llc | |
|
117 W Washington St Shelbyville IN 46176-1245 | |
| (317) 398-2103 | |
| (317) 421-1570 |
| Full Name | Randall L Miller Dds Llc |
|---|---|
| Speciality | Dentist |
| Location | 117 W Washington St, Shelbyville, Indiana |
| Authorized Official Name and Position | Randall Lee Miller (OWNER/DENTIST) |
| Authorized Official Contact | 3173982103 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Randall L Miller Dds Llc 117 W Washington St Shelbyville IN 46176-1245 Ph: (317) 398-2103 | Randall L Miller Dds Llc 117 W Washington St Shelbyville IN 46176-1245 Ph: (317) 398-2103 |
| NPI Number | 1508284837 |
|---|---|
| Provider Enumeration Date | 04/03/2014 |
| Last Update Date | 04/03/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1508284837 | NPI | - | NPPES |
| 100224820A | Medicaid | IN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 12009483A (Indiana) | Primary |
| 122300000X | Dentist | 12010992A (Indiana) | Secondary |
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