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General NPI Number Information
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NPI Number | 1912992207
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Entity Type | Organization
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Legal Business Name | MYERS FAMILY DENTISTRY
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Dates
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Enumeration Date | 09/13/2005
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Last Update Date | 12/29/2010
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Provider Practice Location Address
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Address Line | 211 WASHINGTON HEIGHTS MED CTR
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City | WESTMINSTER
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State | MD
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Zip | 21157-5632
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Country | US
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Telephone | 410-848-8520
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Fax | 410-848-8667
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Provider Business Mailing Address
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Address Line | 211 WASHINGTON HEIGHTS MED CTR
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City | WESTMINSTER
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State | MD
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Zip | 21157-5632
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Country | US
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Telephone | 410-848-8520
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Fax | 410-848-8667
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. JAMES R MYERS JR.
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Credential | DDS
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Telephone | 410-848-8520
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number | 5013
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License Number State | MD
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