Provider Demographics
NPI:1104027929
Name:MEADOWS, GEORGE JOE JR (DMD)
Entity Type:Individual
Prefix:DR
First Name:GEORGE
Middle Name:JOE
Last Name:MEADOWS
Suffix:JR
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14818 7TH AVE E
Mailing Address - Street 2:
Mailing Address - City:BRADENTON
Mailing Address - State:FL
Mailing Address - Zip Code:34212-2902
Mailing Address - Country:US
Mailing Address - Phone:941-745-1143
Mailing Address - Fax:
Practice Address - Street 1:9912 E STATE ROAD 64
Practice Address - Street 2:
Practice Address - City:BRADENTON
Practice Address - State:FL
Practice Address - Zip Code:34212-5303
Practice Address - Country:US
Practice Address - Phone:941-745-1143
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-30
Last Update Date:2011-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL163941223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry