Provider Demographics
NPI:1326809955
Name:MEYER, DENNIS JOSEPH (DDS)
Entity Type:Individual
Prefix:
First Name:DENNIS
Middle Name:JOSEPH
Last Name:MEYER
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 32
Mailing Address - Street 2:
Mailing Address - City:PRINCETON
Mailing Address - State:IN
Mailing Address - Zip Code:47670-0032
Mailing Address - Country:US
Mailing Address - Phone:812-887-6162
Mailing Address - Fax:
Practice Address - Street 1:5124 REFORMATORY RD
Practice Address - Street 2:
Practice Address - City:PENDLETON
Practice Address - State:IN
Practice Address - Zip Code:46064-8767
Practice Address - Country:US
Practice Address - Phone:765-778-8011
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-22
Last Update Date:2024-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN12008808A122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist