Provider Demographics
NPI:1043598188
Name:LIGHTHOUSE FAMILY DENTISTRY
Entity Type:Organization
Organization Name:LIGHTHOUSE FAMILY DENTISTRY
Other - Org Name:DR. E. TAYLOR MEISER, JR. DDS PA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DENTIST/OWNER/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:EDWARD
Authorized Official - Middle Name:TAYLOR
Authorized Official - Last Name:MEISER
Authorized Official - Suffix:JR
Authorized Official - Credentials:DDS
Authorized Official - Phone:410-224-4411
Mailing Address - Street 1:37 OLD SOLOMONS ISLAND RD
Mailing Address - Street 2:
Mailing Address - City:ANNAPOLIS
Mailing Address - State:MD
Mailing Address - Zip Code:21401-3820
Mailing Address - Country:US
Mailing Address - Phone:410-224-4411
Mailing Address - Fax:
Practice Address - Street 1:37 OLD SOLOMONS ISLAND RD
Practice Address - Street 2:
Practice Address - City:ANNAPOLIS
Practice Address - State:MD
Practice Address - Zip Code:21401-3820
Practice Address - Country:US
Practice Address - Phone:410-224-4411
Practice Address - Fax:410-224-1314
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-07-22
Last Update Date:2011-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD6426261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental