Provider Demographics
NPI:1417083411
Name:MERRITT, WOODROW W (DDS MS)
Entity Type:Individual
Prefix:DR
First Name:WOODROW
Middle Name:W
Last Name:MERRITT
Suffix:
Gender:M
Credentials:DDS MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:514 REED RD
Mailing Address - Street 2:
Mailing Address - City:ANDERSON
Mailing Address - State:SC
Mailing Address - Zip Code:29621-2058
Mailing Address - Country:US
Mailing Address - Phone:864-225-3141
Mailing Address - Fax:864-225-3142
Practice Address - Street 1:514 REED RD
Practice Address - Street 2:
Practice Address - City:ANDERSON
Practice Address - State:SC
Practice Address - Zip Code:29621-2058
Practice Address - Country:US
Practice Address - Phone:864-225-3141
Practice Address - Fax:864-225-3142
Is Sole Proprietor?:No
Enumeration Date:2007-02-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC1496-1171223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics