Provider Demographics
NPI:1780603571
Name:MYERS, MICHAEL H (DDS)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:H
Last Name:MYERS
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 1:1250 GREENWOOD AVE
Mailing Address - Street 2:SUITE 2
Mailing Address - City:JENKINTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:19046-2901
Mailing Address - Country:US
Mailing Address - Phone:215-572-0268
Mailing Address - Fax:
Practice Address - Street 1:1250 GREENWOOD AVE
Practice Address - Street 2:SUITE 2
Practice Address - City:JENKINTOWN
Practice Address - State:PA
Practice Address - Zip Code:19046-2901
Practice Address - Country:US
Practice Address - Phone:215-572-0268
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS0193741223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice