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General NPI Number Information
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NPI Number | 1063754984
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Entity Type | Individual
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Provider Name | LAWRENCE J. MEEKMA DDS
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Gender | Male
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Dates
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Enumeration Date | 03/18/2013
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Last Update Date | 03/18/2013
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Provider Practice Location Address
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Address Line | 7400 W COLLEGE DR
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City | PALOS HEIGHTS
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State | IL
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Zip | 60463-1155
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Country | US
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Telephone | 708-448-3399
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Fax | 708-448-2646
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Provider Business Mailing Address
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Address Line | 7400 W COLLEGE DR
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City | PALOS HEIGHTS
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State | IL
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Zip | 60463-1155
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Country | US
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Telephone | 708-448-3399
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Fax | 708-448-2646
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 019.015669
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License Number State | IL
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