Provider Demographics
NPI:1669555108
Name:PAPADEA, MEREDITH LUCIUS (DMD)
Entity type:Individual
Prefix:DR
First Name:MEREDITH
Middle Name:LUCIUS
Last Name:PAPADEA
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:455 RUM GULLY RD
Mailing Address - Street 2:
Mailing Address - City:MURRELLS INLET
Mailing Address - State:SC
Mailing Address - Zip Code:29576-7730
Mailing Address - Country:US
Mailing Address - Phone:843-235-0536
Mailing Address - Fax:
Practice Address - Street 1:9462 OCEAN HIGHWAY
Practice Address - Street 2:
Practice Address - City:PAWLEYS ISLAND
Practice Address - State:SC
Practice Address - Zip Code:29585
Practice Address - Country:US
Practice Address - Phone:843-235-0536
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC39101223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCZX3910Medicaid
SCZA9537Medicaid