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General NPI Number Information
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NPI Number | 1982794921
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Entity Type | Individual
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Provider Name | LARRY J MEYER D.D.S.
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Gender | Male
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Dates
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Enumeration Date | 10/13/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 518 N MAIN ST
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City | YREKA
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State | CA
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Zip | 96097-2542
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Country | US
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Telephone | 530-842-1689
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Fax | 530-842-7487
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Provider Business Mailing Address
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Address Line | 2300 TAYLOR AVE
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City | YREKA
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State | CA
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Zip | 96097
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Country | US
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Telephone | 530-842-5665
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Fax | 530-842-7487
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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 | 20771
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License Number State | CA
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