Provider Demographics
NPI:1144865270
Name:DR PAUL J MEYER PC
Entity type:Organization
Organization Name:DR PAUL J MEYER PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ORTHODONTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:JUEL
Authorized Official - Last Name:MEYER
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:605-695-9148
Mailing Address - Street 1:105 22ND AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKINGS
Mailing Address - State:SD
Mailing Address - Zip Code:57006-2653
Mailing Address - Country:US
Mailing Address - Phone:605-692-7511
Mailing Address - Fax:
Practice Address - Street 1:105 22ND AVE
Practice Address - Street 2:
Practice Address - City:BROOKINGS
Practice Address - State:SD
Practice Address - Zip Code:57006-2653
Practice Address - Country:US
Practice Address - Phone:605-692-7511
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-11-13
Last Update Date:2019-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty