Provider Demographics
NPI:1548451115
Name:MILLAN, DORALIO S (DDS)
Entity type:Individual
Prefix:DR
First Name:DORALIO
Middle Name:S
Last Name:MILLAN
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11130 N KENDALL DR
Mailing Address - Street 2:SUITE 202
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33176-0939
Mailing Address - Country:US
Mailing Address - Phone:305-271-7500
Mailing Address - Fax:305-271-7589
Practice Address - Street 1:11130 N KENDALL DR
Practice Address - Street 2:SUITE 202
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33176-0939
Practice Address - Country:US
Practice Address - Phone:305-271-7500
Practice Address - Fax:305-271-7589
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-07
Last Update Date:2007-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN00137191223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice