Provider Demographics
NPI:1336692417
Name:MEIRICK, DANIELLE MARIE (DDS)
Entity Type:Individual
Prefix:DR
First Name:DANIELLE
Middle Name:MARIE
Last Name:MEIRICK
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 N LIVINGSTON ST
Mailing Address - Street 2:SUITE 301
Mailing Address - City:MADISON
Mailing Address - State:WI
Mailing Address - Zip Code:53703-2326
Mailing Address - Country:US
Mailing Address - Phone:608-467-8022
Mailing Address - Fax:608-819-6948
Practice Address - Street 1:434 SIDNEY ST
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53703-1724
Practice Address - Country:US
Practice Address - Phone:641-780-8412
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-07-26
Last Update Date:2016-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI1001361122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist