Provider Demographics
NPI:1598873564
Name:MEARA, JOHN W JR (DDS)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:W
Last Name:MEARA
Suffix:JR
Gender:M
Credentials:DDS
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Mailing Address - Street 1:309 WALBRIDGE DR
Mailing Address - Street 2:
Mailing Address - City:EAST LANSING
Mailing Address - State:MI
Mailing Address - Zip Code:48823-2035
Mailing Address - Country:US
Mailing Address - Phone:517-351-2327
Mailing Address - Fax:
Practice Address - Street 1:5238 W ST JOE HWY
Practice Address - Street 2:SUITE 2
Practice Address - City:LANSING
Practice Address - State:MI
Practice Address - Zip Code:48917-4085
Practice Address - Country:US
Practice Address - Phone:517-323-1000
Practice Address - Fax:517-886-5566
Is Sole Proprietor?:No
Enumeration Date:2006-08-29
Last Update Date:2008-05-30
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Provider Licenses
StateLicense IDTaxonomies
MI29010084081223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI8337134Medicare PIN