Miller, Matthew Jon
Miller, Matthew Jon is an individual health care provider with primary practice located at 940 Roanoke Ave North Fork Orthodontics, Riverhead NY 11901. He recently has only one registered license in Dental Providers / Orthodontics and Dentofacial Orthopedics, which is considered as his primary health care specialty. Miller, Matthew Jon can be contacted via phone (631) 727-4040.Contact Information
Primary practice address
940 Roanoke Ave North Fork Orthodontics
Riverhead NY 11901
Phone: (631) 727-4040
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / Orthodontics and Dentofacial Orthopedics | 1223X0400X | 057738 | New York |
Profile Details
| NPI number | 1720347859 |
|---|---|
| LBN Legal business name | Miller, Matthew Jon |
| Credentials | Doctor of Dental Surgery (DDS) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | May 9th, 2012 |
| Last updated | Feb 27th, 2017 - about 8 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1720347859 | NPPES |
| New York | MEDICAID | 04588065 |
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