Provider Demographics
NPI:1669572418
Name:MEADE, DENNIS C (DDS)
Entity type:Individual
Prefix:DR
First Name:DENNIS
Middle Name:C
Last Name:MEADE
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 1:1440 MILITARY WEST
Mailing Address - Street 2:#102
Mailing Address - City:BENICIA
Mailing Address - State:CA
Mailing Address - Zip Code:94510-2446
Mailing Address - Country:US
Mailing Address - Phone:707-745-2121
Mailing Address - Fax:707-745-8965
Practice Address - Street 1:1440 MILITARY WEST
Practice Address - Street 2:#102
Practice Address - City:BENICIA
Practice Address - State:CA
Practice Address - Zip Code:94510-2446
Practice Address - Country:US
Practice Address - Phone:707-745-2121
Practice Address - Fax:707-745-8965
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA351441223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice