Provider Demographics
NPI:1245445931
Name:MEEHAN-KIERMEIER, KATHLEEN A (DMD, MS)
Entity type:Individual
Prefix:DR
First Name:KATHLEEN
Middle Name:A
Last Name:MEEHAN-KIERMEIER
Suffix:
Gender:F
Credentials:DMD, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1000 WHITE HORSE RD
Mailing Address - Street 2:SUITE 916
Mailing Address - City:VOORHEES
Mailing Address - State:NJ
Mailing Address - Zip Code:08043-4406
Mailing Address - Country:US
Mailing Address - Phone:856-435-7400
Mailing Address - Fax:
Practice Address - Street 1:1000 WHITE HORSE RD
Practice Address - Street 2:SUITE 916
Practice Address - City:VOORHEES
Practice Address - State:NJ
Practice Address - Zip Code:08043-4406
Practice Address - Country:US
Practice Address - Phone:856-435-7400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22DIO20372001223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics