Provider Demographics
NPI:1417953803
Name:MYERS, AUBREY M (DDS)
Entity Type:Individual
Prefix:DR
First Name:AUBREY
Middle Name:M
Last Name:MYERS
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 1:409 N 35TH ST
Mailing Address - Street 2:
Mailing Address - City:MOREHEAD CITY
Mailing Address - State:NC
Mailing Address - Zip Code:28557-3107
Mailing Address - Country:US
Mailing Address - Phone:252-726-1421
Mailing Address - Fax:252-726-5964
Practice Address - Street 1:409 N 35TH ST
Practice Address - Street 2:
Practice Address - City:MOREHEAD CITY
Practice Address - State:NC
Practice Address - Zip Code:28557-3107
Practice Address - Country:US
Practice Address - Phone:252-726-1421
Practice Address - Fax:252-726-5964
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-06-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC78301223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC902XTOtherBLUE CROSS BLUE SHIELD
NC89902XTMedicaid