Provider Demographics
NPI:1851464697
Name:DRS MEYERS AND NICKOLAS LLC
Entity Type:Organization
Organization Name:DRS MEYERS AND NICKOLAS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR OF DENTAL SURGERY GENERAL
Authorized Official - Prefix:DR
Authorized Official - First Name:PETE
Authorized Official - Middle Name:NICK
Authorized Official - Last Name:NICKOLAS
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:410-848-9540
Mailing Address - Street 1:114 EAST MAIN STREET
Mailing Address - Street 2:
Mailing Address - City:WESTMINSTER
Mailing Address - State:MD
Mailing Address - Zip Code:21157
Mailing Address - Country:US
Mailing Address - Phone:410-848-9540
Mailing Address - Fax:410-848-9661
Practice Address - Street 1:114 EAST MAIN STREET
Practice Address - Street 2:
Practice Address - City:WESTMINSTER
Practice Address - State:MD
Practice Address - Zip Code:21157
Practice Address - Country:US
Practice Address - Phone:410-848-9540
Practice Address - Fax:410-848-9661
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-17
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD5819122300000X
MD5922122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty