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NPI Code Detail

MEDICARE: DR. JOSHUA DALTON MERRILL D.D.S

MEDICARE: DR. JOSHUA DALTON MERRILL D.D.S
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
1122300000XDentist30-022573OH

General Provider Information

NPI Number : 1952508855
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JOSHUA DALTON MERRILL D.D.S
Provider Business Mailing Address
First Line : 63 E MAIN ST
Second Line :
City : NEW LONDON
State : OH
Zip : 44851-1233
Country : US
Telephone Number : 419-929-1544
Fax Number : 419-929-0402
Provider Business Practice Location Address
First Line : 63 E MAIN ST
Second Line :
City : NEW LONDON
State : OH
Zip : 44851-1233
Country : US
Telephone Number : 419-929-1544
Fax Number : 419-929-0402
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/02/2007
Last Update Date : 07/08/2007

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