Provider Demographics
NPI:1437125663
Name:MILLER, KIM A (DDS)
Entity type:Individual
Prefix:DR
First Name:KIM
Middle Name:A
Last Name:MILLER
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:1010 HIGH HOUSE RD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:CARY
Mailing Address - State:NC
Mailing Address - Zip Code:27513-3576
Mailing Address - Country:US
Mailing Address - Phone:919-461-9601
Mailing Address - Fax:919-461-9850
Practice Address - Street 1:1010 HIGH HOUSE RD
Practice Address - Street 2:SUITE 200
Practice Address - City:CARY
Practice Address - State:NC
Practice Address - Zip Code:27513-3576
Practice Address - Country:US
Practice Address - Phone:919-461-9601
Practice Address - Fax:919-461-9850
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-02-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC63021223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice