Provider Demographics
NPI:1538382981
Name:MYERS, CECIL O (DMD)
Entity type:Individual
Prefix:DR
First Name:CECIL
Middle Name:O
Last Name:MYERS
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:105 MAYO ST
Mailing Address - Street 2:
Mailing Address - City:AMERICUS
Mailing Address - State:GA
Mailing Address - Zip Code:31709-3742
Mailing Address - Country:US
Mailing Address - Phone:229-924-2746
Mailing Address - Fax:229-924-8290
Practice Address - Street 1:105 MAYO ST
Practice Address - Street 2:
Practice Address - City:AMERICUS
Practice Address - State:GA
Practice Address - Zip Code:31709-3742
Practice Address - Country:US
Practice Address - Phone:229-924-2746
Practice Address - Fax:229-924-8290
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA84361223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice