Provider Demographics
NPI:1932491479
Name:MEYLIKER, ROMAN GREGORY (DMD)
Entity Type:Individual
Prefix:
First Name:ROMAN
Middle Name:GREGORY
Last Name:MEYLIKER
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 1:54 W JIMMIE LEEDS RD STE 6
Mailing Address - Street 2:
Mailing Address - City:GALLOWAY
Mailing Address - State:NJ
Mailing Address - Zip Code:08205-9438
Mailing Address - Country:US
Mailing Address - Phone:609-748-9600
Mailing Address - Fax:609-748-9611
Practice Address - Street 1:54 W JIMMIE LEEDS RD STE 6
Practice Address - Street 2:
Practice Address - City:GALLOWAY
Practice Address - State:NJ
Practice Address - Zip Code:08205-9438
Practice Address - Country:US
Practice Address - Phone:609-748-9600
Practice Address - Fax:609-748-9611
Is Sole Proprietor?:No
Enumeration Date:2011-05-03
Last Update Date:2015-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22DI026010001223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery