Provider Demographics
NPI:1679023949
Name:MILLER, PRESTON SCOTT (DDS)
Entity type:Individual
Prefix:
First Name:PRESTON
Middle Name:SCOTT
Last Name:MILLER
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 1:5985 S 3500 W
Mailing Address - Street 2:
Mailing Address - City:ROY
Mailing Address - State:UT
Mailing Address - Zip Code:84067-9003
Mailing Address - Country:US
Mailing Address - Phone:801-985-4000
Mailing Address - Fax:801-985-4000
Practice Address - Street 1:5985 S 3500 W
Practice Address - Street 2:
Practice Address - City:ROY
Practice Address - State:UT
Practice Address - Zip Code:84067-9003
Practice Address - Country:US
Practice Address - Phone:801-985-4000
Practice Address - Fax:801-985-4000
Is Sole Proprietor?:No
Enumeration Date:2016-10-10
Last Update Date:2024-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT14015318-99261223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice