Provider Demographics
NPI:1518170828
Name:MEYERS, RAYMOND FREDERICK (DMD)
Entity Type:Individual
Prefix:
First Name:RAYMOND
Middle Name:FREDERICK
Last Name:MEYERS
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:289 S TRADE ST
Mailing Address - Street 2:
Mailing Address - City:TRYON
Mailing Address - State:NC
Mailing Address - Zip Code:28782-3805
Mailing Address - Country:US
Mailing Address - Phone:828-859-6640
Mailing Address - Fax:828-859-2877
Practice Address - Street 1:289 S TRADE ST
Practice Address - Street 2:
Practice Address - City:TRYON
Practice Address - State:NC
Practice Address - Zip Code:28782-3805
Practice Address - Country:US
Practice Address - Phone:828-859-6640
Practice Address - Fax:828-859-2877
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC54091223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice