Provider Demographics
NPI:1801919345
Name:MEEKS, VERNON DALE (DMD)
Entity type:Individual
Prefix:DR
First Name:VERNON
Middle Name:DALE
Last Name:MEEKS
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:980 MOUNT HOMER RD
Mailing Address - Street 2:
Mailing Address - City:EUSTIS
Mailing Address - State:FL
Mailing Address - Zip Code:32726-6258
Mailing Address - Country:US
Mailing Address - Phone:352-357-7900
Mailing Address - Fax:352-357-3344
Practice Address - Street 1:980 MOUNT HOMER RD
Practice Address - Street 2:
Practice Address - City:EUSTIS
Practice Address - State:FL
Practice Address - Zip Code:32726-6258
Practice Address - Country:US
Practice Address - Phone:352-357-7900
Practice Address - Fax:352-357-3344
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL82221223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice