Provider Demographics
NPI:1811054653
Name:MERRETT, JAMES PATRICK EDWARD (DDS)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:PATRICK EDWARD
Last Name:MERRETT
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 1:9902 POTRANCO RD
Mailing Address - Street 2:107
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78251-9609
Mailing Address - Country:US
Mailing Address - Phone:210-520-3400
Mailing Address - Fax:
Practice Address - Street 1:9902 POTRANCO RD
Practice Address - Street 2:107
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78251-9609
Practice Address - Country:US
Practice Address - Phone:210-520-3400
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-02
Last Update Date:2014-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI1847122300000X
CA40468122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist