Provider Demographics
NPI:1922219377
Name:MEYER, SAMUEL ALAN (DDS)
Entity Type:Individual
Prefix:DR
First Name:SAMUEL
Middle Name:ALAN
Last Name:MEYER
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:506 DAVID DR
Mailing Address - Street 2:
Mailing Address - City:BEL AIR
Mailing Address - State:MD
Mailing Address - Zip Code:21015-6197
Mailing Address - Country:US
Mailing Address - Phone:410-569-1572
Mailing Address - Fax:
Practice Address - Street 1:30 MIDDLE RIVER RD
Practice Address - Street 2:
Practice Address - City:MIDDLE RIVER
Practice Address - State:MD
Practice Address - Zip Code:21220-4114
Practice Address - Country:US
Practice Address - Phone:410-686-6510
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD12751122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist