Provider Demographics
NPI:1538380456
Name:MILLER, ROBERT STANLEY (DMD)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:STANLEY
Last Name:MILLER
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:94 DIAMOND SPRING RD
Mailing Address - Street 2:
Mailing Address - City:DENVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:07834-2775
Mailing Address - Country:US
Mailing Address - Phone:973-627-3064
Mailing Address - Fax:973-627-3066
Practice Address - Street 1:94 DIAMOND SPRING RD
Practice Address - Street 2:
Practice Address - City:DENVILLE
Practice Address - State:NJ
Practice Address - Zip Code:07834-2775
Practice Address - Country:US
Practice Address - Phone:973-627-3064
Practice Address - Fax:973-627-3066
Is Sole Proprietor?:No
Enumeration Date:2007-05-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ10521122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist