Provider Demographics
NPI:1811051220
Name:MESLOH, FREDERICK DOUGLAS (DDS)
Entity type:Individual
Prefix:DR
First Name:FREDERICK
Middle Name:DOUGLAS
Last Name:MESLOH
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 1:7 SUMMERFIELD CT
Mailing Address - Street 2:
Mailing Address - City:GORHAM
Mailing Address - State:ME
Mailing Address - Zip Code:04038-2780
Mailing Address - Country:US
Mailing Address - Phone:413-834-0474
Mailing Address - Fax:
Practice Address - Street 1:7 SUMMERFIELD CT
Practice Address - Street 2:
Practice Address - City:GORHAM
Practice Address - State:ME
Practice Address - Zip Code:04038-2780
Practice Address - Country:US
Practice Address - Phone:413-834-0474
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-20
Last Update Date:2019-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEDEN45161223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice