Coletta M Miller in Quincy - Oral And Maxillofacial Surgery
Coletta M Miller - NPI 1760488514
Coletta M Miller is a Oral And Maxillofacial Surgery in Quincy, Illinois. Coletta M Miller practices all healthcare services and medical treatments related to Oral And Maxillofacial Surgery. The NPI Number for Coletta M Miller is 1760488514. The last update date is 2010-08-27.
Coletta M Miller's current location address is 3740 E Lake Ctr, Quincy, Illinois. You can contact this provider via phone number 2172246789 and fax number 2172249675. The mailing address for Coletta M Miller is 3740 E Lake Ctr, Quincy, Illinois. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Coletta M Miller |
|---|---|
| Address | 3740 E Lake Ctr, Quincy, Illinois |
| Phone Number | 2172246789 |
| Fax Number | 2172249675 |
| Sole Proprietor | Y |
| Credentials | D.D.S. |
NPI Number Detail
| NPI Number | 1760488514 |
|---|---|
| Provider Enumeration Date | 2005-06-27 |
| Last Updated Date | 2010-08-27 |
Provider Mailing Address Detail
| Address | 3740 E Lake Ctr |
|---|---|
| City | Quincy |
| State | Illinois (IL) |
| Post Code | 623055805 |
| Phone Number | 2172246789 |
| Fax Number | 2172249675 |
Provider's Primary Taxonomy Detail
| Speciality | Oral And Maxillofacial Surgery |
|---|---|
| Taxonomy | 1223S0112X |
| Licence No | 021-001383 |
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Definition: The specialty of dentistry which includes the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region. |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 589937 | IA | -- | |
| 102687 | IL | -- |
Post Comment/ Review Below
What is the unique identifier code issued to Coletta M Miller by the Centers for Medicare & Medicaid Services?
The Coletta M Miller has been assigned the NPI (National Provider Identifier) 1760488514. This 10-digit code serves as a unique identification number for healthcare providers issued by the Centers for Medicare & Medicaid Services (CMS).
Could you please provide the complete street address where Coletta M Miller is physically located?
The Coletta M Miller is physically situated at the following address: 3740 E Lake Ctr, Quincy, IL, 623055805.
What is the Coletta M Miller's specialty and taxonomy code?
The Coletta M Miller's specialty is Oral And Maxillofacial Surgery, and the corresponding taxonomy code is 1223S0112X.
On what date did the Coletta M Miller receive its 1760488514 assignment from the Centers for Medicare & Medicaid Services?
The Coletta M Miller was assigned its 1760488514 by the Centers for Medicare & Medicaid Services on 2005-06-27.
As of what date were the details related to Coletta M Miller most recently updated or revised?
The information pertaining to Coletta M Miller, including its address, specialty, and other relevant details, was last updated or revised on 2010-08-27.