Provider Demographics
NPI:1013015718
Name:WESLEY E. MEYERS, DMD, PA
Entity Type:Organization
Organization Name:WESLEY E. MEYERS, DMD, PA
Other - Org Name:ALOMA PARK DENTAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:WESLEY
Authorized Official - Middle Name:E
Authorized Official - Last Name:MEYERS
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:407-671-8901
Mailing Address - Street 1:6001 BRICK CT
Mailing Address - Street 2:STE 101
Mailing Address - City:WINTER PARK
Mailing Address - State:FL
Mailing Address - Zip Code:32792
Mailing Address - Country:US
Mailing Address - Phone:407-671-8901
Mailing Address - Fax:407-677-6368
Practice Address - Street 1:6001 BRICK CT
Practice Address - Street 2:STE 101
Practice Address - City:WINTER PARK
Practice Address - State:FL
Practice Address - Zip Code:32792
Practice Address - Country:US
Practice Address - Phone:407-671-8901
Practice Address - Fax:407-677-6368
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-20
Last Update Date:2008-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL52611223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty