Provider Demographics
NPI:1225647514
Name:DRS MESH, P.C.
Entity Type:Organization
Organization Name:DRS MESH, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRES./CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:JOE
Authorized Official - Middle Name:E
Authorized Official - Last Name:MESH
Authorized Official - Suffix:
Authorized Official - Credentials:DMD, CAGS (PROSTHO)
Authorized Official - Phone:810-750-1000
Mailing Address - Street 1:15555 SILVER PARKWAY
Mailing Address - Street 2:
Mailing Address - City:FENTON
Mailing Address - State:MI
Mailing Address - Zip Code:48430
Mailing Address - Country:US
Mailing Address - Phone:810-750-1000
Mailing Address - Fax:810-750-1030
Practice Address - Street 1:15555 SILVER PARKWAY
Practice Address - Street 2:
Practice Address - City:FENTON
Practice Address - State:MI
Practice Address - Zip Code:48430
Practice Address - Country:US
Practice Address - Phone:810-750-1000
Practice Address - Fax:810-750-1030
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-07-23
Last Update Date:2020-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0700XDental ProvidersDentistProsthodonticsGroup - Multi-Specialty
No1223E0200XDental ProvidersDentistEndodonticsGroup - Multi-Specialty
No1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty