Provider Demographics
NPI:1790533768
Name:DAVID A MERRELL DMD PA
Entity type:Organization
Organization Name:DAVID A MERRELL DMD PA
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:ALAN
Authorized Official - Last Name:MERRELL
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:828-645-3482
Mailing Address - Street 1:205 FLAT CREEK VILLAGE DR
Mailing Address - Street 2:
Mailing Address - City:WEAVERVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28787-6211
Mailing Address - Country:US
Mailing Address - Phone:828-645-3482
Mailing Address - Fax:828-645-3703
Practice Address - Street 1:205 FLAT CREEK VILLAGE DR
Practice Address - Street 2:
Practice Address - City:WEAVERVILLE
Practice Address - State:NC
Practice Address - Zip Code:28787-6211
Practice Address - Country:US
Practice Address - Phone:828-645-3482
Practice Address - Fax:828-645-3703
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-05-07
Last Update Date:2024-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty
No332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized EquipmentGroup - Multi-Specialty