Provider Demographics
NPI:1043311426
Name:MEAGHER, JOHN RICHARD (DDS)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:RICHARD
Last Name:MEAGHER
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 1:10633 LIMBURG FORKS RD
Mailing Address - Street 2:
Mailing Address - City:CARTHAGE
Mailing Address - State:NY
Mailing Address - Zip Code:13619-3105
Mailing Address - Country:US
Mailing Address - Phone:315-493-3969
Mailing Address - Fax:315-493-9048
Practice Address - Street 1:40 FRANKLIN ST
Practice Address - Street 2:SUITE 111
Practice Address - City:CARTHAGE
Practice Address - State:NY
Practice Address - Zip Code:13619-1323
Practice Address - Country:US
Practice Address - Phone:315-493-1581
Practice Address - Fax:315-493-9048
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY030590-11223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice