Provider Demographics
NPI:1578602116
Name:MEYERS, DANIEL M (DDS, MS)
Entity Type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:M
Last Name:MEYERS
Suffix:
Gender:M
Credentials:DDS, MS
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Other - First Name:
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Mailing Address - Street 1:550 SAINT MICHAELS DR
Mailing Address - Street 2:SUITE A
Mailing Address - City:SANTA FE
Mailing Address - State:NM
Mailing Address - Zip Code:87505-7604
Mailing Address - Country:US
Mailing Address - Phone:505-983-8605
Mailing Address - Fax:505-983-5441
Practice Address - Street 1:550 SAINT MICHAELS DR
Practice Address - Street 2:SUITE A
Practice Address - City:SANTA FE
Practice Address - State:NM
Practice Address - Zip Code:87505-7604
Practice Address - Country:US
Practice Address - Phone:505-983-8605
Practice Address - Fax:505-983-5441
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NMDD24401223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics