Provider Demographics
NPI:1568728574
Name:MEYER, WAYNE EMIL (DDS)
Entity Type:Individual
Prefix:DR
First Name:WAYNE
Middle Name:EMIL
Last Name:MEYER
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 1:3441 BRITTANY WAY
Mailing Address - Street 2:
Mailing Address - City:EL DORADO HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:95762-3950
Mailing Address - Country:US
Mailing Address - Phone:707-688-5514
Mailing Address - Fax:
Practice Address - Street 1:3441 BRITTANY WAY
Practice Address - Street 2:
Practice Address - City:EL DORADO HILLS
Practice Address - State:CA
Practice Address - Zip Code:95762-3950
Practice Address - Country:US
Practice Address - Phone:707-688-5514
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-04-03
Last Update Date:2012-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA18997122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist