Provider Demographics
NPI:1811020324
Name:MEISTER, FRED J (DMD)
Entity Type:Individual
Prefix:DR
First Name:FRED
Middle Name:J
Last Name:MEISTER
Suffix:
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 1:3062 W PARRISH AVE
Mailing Address - Street 2:
Mailing Address - City:OWENSBORO
Mailing Address - State:KY
Mailing Address - Zip Code:42301-2695
Mailing Address - Country:US
Mailing Address - Phone:270-926-2057
Mailing Address - Fax:270-926-7479
Practice Address - Street 1:3062 W PARRISH AVE
Practice Address - Street 2:
Practice Address - City:OWENSBORO
Practice Address - State:KY
Practice Address - Zip Code:42301-2695
Practice Address - Country:US
Practice Address - Phone:270-926-2057
Practice Address - Fax:270-926-7479
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYKY4227122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist