Provider Demographics
NPI:1770629867
Name:TERRY L. MYERS, DDS, PC
Entity Type:Organization
Organization Name:TERRY L. MYERS, DDS, PC
Other - Org Name:KEYSTONE DENTISTRY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:TERRY
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:MYERS
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:816-331-4200
Mailing Address - Street 1:109 APPLE VALLEY PKWY
Mailing Address - Street 2:
Mailing Address - City:BELTON
Mailing Address - State:MO
Mailing Address - Zip Code:64012-4725
Mailing Address - Country:US
Mailing Address - Phone:816-331-4200
Mailing Address - Fax:816-331-4051
Practice Address - Street 1:109 APPLE VALLEY PKWY
Practice Address - Street 2:
Practice Address - City:BELTON
Practice Address - State:MO
Practice Address - Zip Code:64012-4725
Practice Address - Country:US
Practice Address - Phone:816-331-4200
Practice Address - Fax:816-331-4051
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-29
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO148011223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty