Provider Demographics
NPI:1326110180
Name:MENG, THOMAS R JR (DDS)
Entity Type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:R
Last Name:MENG
Suffix:JR
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:12165 W CENTER RD
Mailing Address - Street 2:SUITE 76
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68144-3962
Mailing Address - Country:US
Mailing Address - Phone:402-334-8083
Mailing Address - Fax:402-334-0834
Practice Address - Street 1:12165 W CENTER RD
Practice Address - Street 2:SUITE 76
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68144-3962
Practice Address - Country:US
Practice Address - Phone:402-334-8083
Practice Address - Fax:402-334-0834
Is Sole Proprietor?:No
Enumeration Date:2006-11-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE56491223P0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0700XDental ProvidersDentistProsthodontics