Healthcare Provider Details

I. General information

NPI: 1740206598
Provider Name (Legal Business Name): STUART H MEYER DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/14/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1315 ALLAIRE AVE
OCEAN NJ
07712-3549
US

IV. Provider business mailing address

12 KIMBERLY DR
OCEAN NJ
07712-3319
US

V. Phone/Fax

Practice location:
  • Phone: 732-531-4400
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0106X
TaxonomyOral and Maxillofacial Pathology Dentistry
License NumberDI 15975
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: