Provider Demographics
NPI:1023555901
Name:SUSAN MEINERZ DDS, LLC
Entity Type:Organization
Organization Name:SUSAN MEINERZ DDS, LLC
Other - Org Name:HONEST TEETH DENTISTRY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MAXWELL
Authorized Official - Middle Name:
Authorized Official - Last Name:MEINERZ
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:414-218-8312
Mailing Address - Street 1:890 ELM GROVE RD
Mailing Address - Street 2:SUITE 106
Mailing Address - City:ELM GROVE
Mailing Address - State:WI
Mailing Address - Zip Code:53122-2528
Mailing Address - Country:US
Mailing Address - Phone:262-784-7770
Mailing Address - Fax:
Practice Address - Street 1:890 ELM GROVE RD
Practice Address - Street 2:SUITE 106
Practice Address - City:ELM GROVE
Practice Address - State:WI
Practice Address - Zip Code:53122-2528
Practice Address - Country:US
Practice Address - Phone:262-784-7770
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-01-30
Last Update Date:2017-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty