Provider Demographics
NPI:1609872092
Name:MEYERS, GALEN FRANK JR (DDS)
Entity Type:Individual
Prefix:DR
First Name:GALEN
Middle Name:FRANK
Last Name:MEYERS
Suffix:JR
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 1:19325 S TRENT JONES DR
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70810-6039
Mailing Address - Country:US
Mailing Address - Phone:225-756-4518
Mailing Address - Fax:225-756-4518
Practice Address - Street 1:19325 S TRENT JONES DR
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70810-6039
Practice Address - Country:US
Practice Address - Phone:225-756-4518
Practice Address - Fax:225-756-4518
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-22
Last Update Date:2017-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA30891223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice