Provider Demographics
NPI:1053471466
Name:MELTZNER, STEVEN D (DMD)
Entity Type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:D
Last Name:MELTZNER
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:4140 W MEMORIAL RD
Mailing Address - Street 2:THE PLAZA #201
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73120-8366
Mailing Address - Country:US
Mailing Address - Phone:405-749-4267
Mailing Address - Fax:405-749-4269
Practice Address - Street 1:4140 W MEMORIAL RD
Practice Address - Street 2:THE PLAZA #201
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73120-8366
Practice Address - Country:US
Practice Address - Phone:405-749-4267
Practice Address - Fax:405-749-4269
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-08
Last Update Date:2008-07-25
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OK36901223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
OKT79982Medicare UPIN