Provider Demographics
NPI:1609961762
Name:SCOTT MEYER DDS LLC
Entity Type:Organization
Organization Name:SCOTT MEYER DDS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:J
Authorized Official - Last Name:MEYER
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:314-894-9700
Mailing Address - Street 1:4409 MERAMEC BOTTOM RD
Mailing Address - Street 2:SUITE F
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63129-2562
Mailing Address - Country:US
Mailing Address - Phone:314-894-9700
Mailing Address - Fax:314-894-9709
Practice Address - Street 1:4409 MERAMEC BOTTOM RD
Practice Address - Street 2:SUITE F
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63129-2562
Practice Address - Country:US
Practice Address - Phone:314-894-9700
Practice Address - Fax:314-894-9709
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-04
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO154111223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty