Provider Demographics
NPI:1447236591
Name:MERRITT, JANELLE ANN (RDH)
Entity Type:Individual
Prefix:MRS
First Name:JANELLE
Middle Name:ANN
Last Name:MERRITT
Suffix:
Gender:F
Credentials:RDH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PSC 811 BOX 483
Mailing Address - Street 2:
Mailing Address - City:FPO
Mailing Address - State:AE
Mailing Address - Zip Code:09609
Mailing Address - Country:IT
Mailing Address - Phone:01139-077-1709
Mailing Address - Fax:
Practice Address - Street 1:NBHC GAETA ITALY
Practice Address - Street 2:
Practice Address - City:FPO
Practice Address - State:AE
Practice Address - Zip Code:09609
Practice Address - Country:IT
Practice Address - Phone:01139-077-1709
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-12-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD1264124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist