MEDICARE: DR. VERA RENEE POLINTAN MEYER DMD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	122300000X	Dentist	DDS36821	CA

General Provider Information

NPI Number	:	1124285648
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. VERA RENEE POLINTAN MEYER DMD

Provider Business Mailing Address
First Line	:	891 SIR FRANCIS DRAKE BLVD
Second Line	:
City	:	SAN ANSELMO
State	:	CA
Zip	:	94960-1916
Country	:	US
Telephone Number	:	415-456-2273
Fax Number	:	415-456-2273

Provider Business Practice Location Address
First Line	:	891 SIR FRANCIS DRAKE BLVD
Second Line	:
City	:	SAN ANSELMO
State	:	CA
Zip	:	94960-1916
Country	:	US
Telephone Number	:	415-456-2273
Fax Number	:	415-456-2273

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/21/2008
Last Update Date	:	05/11/2012

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