Provider Demographics
NPI:1649443706
Name:ROBERT J MEALY,III.P.C.
Entity type:Organization
Organization Name:ROBERT J MEALY,III.P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:JAMES
Authorized Official - Last Name:MEALY
Authorized Official - Suffix:III
Authorized Official - Credentials:DDS
Authorized Official - Phone:757-543-7973
Mailing Address - Street 1:2737 CAMPOSTELLA RD
Mailing Address - Street 2:
Mailing Address - City:CHESAPEAKE
Mailing Address - State:VA
Mailing Address - Zip Code:23324-3656
Mailing Address - Country:US
Mailing Address - Phone:757-543-7973
Mailing Address - Fax:757-543-7926
Practice Address - Street 1:2737 CAMPOSTELLA RD
Practice Address - Street 2:
Practice Address - City:CHESAPEAKE
Practice Address - State:VA
Practice Address - Zip Code:23324-3656
Practice Address - Country:US
Practice Address - Phone:757-543-7973
Practice Address - Fax:757-543-7926
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-10
Last Update Date:2008-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA04010050581223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty