Healthcare Provider Details

I. General information

NPI: 1073608196
Provider Name (Legal Business Name): ELIZABETH A MEYER DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/04/2006
Last Update Date: 06/24/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

709 S MARKET ST
DANVILLE OH
43014
US

IV. Provider business mailing address

709 S MARKET ST P. O. BOX 3
DANVILLE OH
43014
US

V. Phone/Fax

Practice location:
  • Phone: 740-599-6882
  • Fax:
Mailing address:
  • Phone: 740-599-6882
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number30021328
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: