Provider Demographics
NPI:1477784890
Name:MEYERHOF, PETER G (DDS)
Entity Type:Individual
Prefix:
First Name:PETER
Middle Name:G
Last Name:MEYERHOF
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:684 W. NAPA ST.
Mailing Address - Street 2:
Mailing Address - City:SONOMA
Mailing Address - State:CA
Mailing Address - Zip Code:95476
Mailing Address - Country:US
Mailing Address - Phone:707-996-8833
Mailing Address - Fax:707-996-8844
Practice Address - Street 1:684 W. NAPA ST.
Practice Address - Street 2:
Practice Address - City:SONOMA
Practice Address - State:CA
Practice Address - Zip Code:95476
Practice Address - Country:US
Practice Address - Phone:707-996-8833
Practice Address - Fax:707-996-8844
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-03
Last Update Date:2009-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA37974122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist