Provider Demographics
NPI:1891924692
Name:MEEKS, SAMUEL ADAM (DMD)
Entity Type:Individual
Prefix:DR
First Name:SAMUEL
Middle Name:ADAM
Last Name:MEEKS
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 1:10760 GALAXIA PARK DR NW
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87114-5168
Mailing Address - Country:US
Mailing Address - Phone:505-898-1114
Mailing Address - Fax:
Practice Address - Street 1:10760 GALAXIA PARK DR NW
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87114-5168
Practice Address - Country:US
Practice Address - Phone:505-898-1114
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-14
Last Update Date:2009-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMDRES36-09122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist