Provider Demographics
NPI:1629827985
Name:MEYER DENTAL CONCEPT, LLC
Entity type:Organization
Organization Name:MEYER DENTAL CONCEPT, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SHAINA
Authorized Official - Middle Name:ELIZABETH
Authorized Official - Last Name:MEYER
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:740-938-3384
Mailing Address - Street 1:118 GRACELAND BLVD # 214
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43214-1530
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:65 E GRANVILLE ST
Practice Address - Street 2:
Practice Address - City:SUNBURY
Practice Address - State:OH
Practice Address - Zip Code:43074-9130
Practice Address - Country:US
Practice Address - Phone:740-938-3384
Practice Address - Fax:740-205-9062
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-05-17
Last Update Date:2024-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty