MEDICARE: MEERON PLLC

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

General Provider Information

NPI Number	:	1801268602
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MEERON PLLC

Provider Business Mailing Address
First Line	:	3705 E ROSEDALE ST # 141
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76105-1702
Country	:	US
Telephone Number	:	801-663-4222
Fax Number	:

Provider Business Practice Location Address
First Line	:	3705 E ROSEDALE ST # 141
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76105-1702
Country	:	US
Telephone Number	:	801-663-4222
Fax Number	:

Authorized Official
Title or Position	:	DENTIST
Name	:	DR. AARON SALMON
Credential	:
Telephone Number	:	801-663-4222

Provider Enumeration Date	:	10/20/2015
Last Update Date	:	10/20/2015

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