Provider Demographics
NPI:1245562362
Name:MEANS, GARY B (DMD)
Entity Type:Individual
Prefix:DR
First Name:GARY
Middle Name:B
Last Name:MEANS
Suffix:
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 1:99 ERIE ST
Mailing Address - Street 2:
Mailing Address - City:EDINBORO
Mailing Address - State:PA
Mailing Address - Zip Code:16412-6015
Mailing Address - Country:US
Mailing Address - Phone:814-734-4444
Mailing Address - Fax:814-734-4440
Practice Address - Street 1:99 ERIE ST
Practice Address - Street 2:
Practice Address - City:EDINBORO
Practice Address - State:PA
Practice Address - Zip Code:16412-6015
Practice Address - Country:US
Practice Address - Phone:814-734-4444
Practice Address - Fax:814-734-4440
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-01
Last Update Date:2010-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS017958L122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist