Provider Demographics
NPI:1043219199
Name:MEIER, ALLEN WESLEY (DDS)
Entity Type:Individual
Prefix:DR
First Name:ALLEN
Middle Name:WESLEY
Last Name:MEIER
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:3901 HAGAN ST
Mailing Address - Street 2:SUITE B
Mailing Address - City:BLOOMINGTON
Mailing Address - State:IN
Mailing Address - Zip Code:47401-8557
Mailing Address - Country:US
Mailing Address - Phone:812-333-6363
Mailing Address - Fax:812-333-1196
Practice Address - Street 1:3901 HAGAN ST
Practice Address - Street 2:SUITE B
Practice Address - City:BLOOMINGTON
Practice Address - State:IN
Practice Address - Zip Code:47401-8557
Practice Address - Country:US
Practice Address - Phone:812-333-6363
Practice Address - Fax:812-333-1196
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-07-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN12009256A1223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics