Provider Demographics
NPI:1588682314
Name:MICHAEL J MEON DMD PA
Entity Type:Organization
Organization Name:MICHAEL J MEON DMD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:JOHN
Authorized Official - Last Name:MEON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:205-988-4470
Mailing Address - Street 1:2041 VALLEYDALE RD
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35244-2007
Mailing Address - Country:US
Mailing Address - Phone:205-988-4470
Mailing Address - Fax:205-988-4462
Practice Address - Street 1:2041 VALLEYDALE RD
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35244-2007
Practice Address - Country:US
Practice Address - Phone:205-988-4470
Practice Address - Fax:205-988-4462
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-18
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL3056261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental