Provider Demographics
NPI:1710094016
Name:MEYER, SCOTT JOSEPH (DDS)
Entity Type:Individual
Prefix:DR
First Name:SCOTT
Middle Name:JOSEPH
Last Name:MEYER
Suffix:
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 1:752 FORDER CROSSING CT
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63129-2500
Mailing Address - Country:US
Mailing Address - Phone:314-892-8017
Mailing Address - Fax:
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
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO154111223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice