Provider Demographics
NPI:1760599120
Name:MEEKS, GARRY JR (DMD)
Entity Type:Individual
Prefix:DR
First Name:GARRY
Middle Name:
Last Name:MEEKS
Suffix:JR
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11708 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:MIDDLETOWN
Mailing Address - State:KY
Mailing Address - Zip Code:40243-1426
Mailing Address - Country:US
Mailing Address - Phone:502-245-8627
Mailing Address - Fax:502-245-9395
Practice Address - Street 1:911 PALATKA RD
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40214-3461
Practice Address - Country:US
Practice Address - Phone:502-366-2448
Practice Address - Fax:859-289-8153
Is Sole Proprietor?:No
Enumeration Date:2006-08-23
Last Update Date:2016-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY76291223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice