Healthcare Provider Details

I. General information

NPI: 1699786418
Provider Name (Legal Business Name): RICHARD C MEYER D.D.S., M.S.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/10/2006
Last Update Date: 12/29/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10319 W MARKHAM ST STE. 200
LITTLE ROCK AR
72205-2186
US

IV. Provider business mailing address

10319 W MARKHAM ST STE. 200
LITTLE ROCK AR
72205-2186
US

V. Phone/Fax

Practice location:
  • Phone: 501-227-4848
  • Fax: 501-227-5104
Mailing address:
  • Phone: 501-227-4848
  • Fax: 501-227-5104

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223X0400X
TaxonomyOrthodontics and Dentofacial Orthopedics Dentistry
License Number1878
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: