Provider Demographics
NPI:1417153602
Name:MEYER, RACHEL T (DDS)
Entity Type:Individual
Prefix:
First Name:RACHEL
Middle Name:T
Last Name:MEYER
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 1:5100 EDEN AVE
Mailing Address - Street 2:206
Mailing Address - City:EDINA
Mailing Address - State:MN
Mailing Address - Zip Code:55436-2337
Mailing Address - Country:US
Mailing Address - Phone:952-929-0641
Mailing Address - Fax:952-224-9790
Practice Address - Street 1:5001 WINNETKA AVE N
Practice Address - Street 2:
Practice Address - City:NEW HOPE
Practice Address - State:MN
Practice Address - Zip Code:55428-4230
Practice Address - Country:US
Practice Address - Phone:763-533-0055
Practice Address - Fax:763-533-0057
Is Sole Proprietor?:No
Enumeration Date:2007-06-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MND124311223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice