Provider Demographics
NPI:1881882942
Name:MERRIAN, STUART (DMD)
Entity type:Individual
Prefix:DR
First Name:STUART
Middle Name:
Last Name:MERRIAN
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 1:535 MONMOUTH ST
Mailing Address - Street 2:
Mailing Address - City:GLOUCESTER CITY
Mailing Address - State:NJ
Mailing Address - Zip Code:08030-1502
Mailing Address - Country:US
Mailing Address - Phone:856-456-2682
Mailing Address - Fax:856-456-4668
Practice Address - Street 1:535 MONMOUTH ST
Practice Address - Street 2:
Practice Address - City:GLOUCESTER CITY
Practice Address - State:NJ
Practice Address - Zip Code:08030-1502
Practice Address - Country:US
Practice Address - Phone:856-456-2682
Practice Address - Fax:856-456-4668
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-13
Last Update Date:2007-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJDI156071223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice