Provider Demographics
NPI:1861838104
Name:MONTEREY PENINSULA ENDODONTICS
Entity Type:Organization
Organization Name:MONTEREY PENINSULA ENDODONTICS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:
Authorized Official - Last Name:MECKLER
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:831-373-1377
Mailing Address - Street 1:920 CASS STREET SUITE 100
Mailing Address - Street 2:
Mailing Address - City:MONTEREY
Mailing Address - State:CA
Mailing Address - Zip Code:93940
Mailing Address - Country:US
Mailing Address - Phone:831-373-1377
Mailing Address - Fax:831-372-0463
Practice Address - Street 1:920 CASS STREET SUITE 100
Practice Address - Street 2:
Practice Address - City:MONTEREY
Practice Address - State:CA
Practice Address - Zip Code:93940
Practice Address - Country:US
Practice Address - Phone:831-373-1377
Practice Address - Fax:831-372-0463
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-05-14
Last Update Date:2014-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty