Provider Demographics
NPI:1104155423
Name:MENG, JOSEPH CHARLES (DDS, MS)
Entity type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:CHARLES
Last Name:MENG
Suffix:
Gender:M
Credentials:DDS, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2315 MCDONALD AVE STE 310
Mailing Address - Street 2:
Mailing Address - City:MISSOULA
Mailing Address - State:MT
Mailing Address - Zip Code:59801-7347
Mailing Address - Country:US
Mailing Address - Phone:406-543-5647
Mailing Address - Fax:
Practice Address - Street 1:2315 MCDONALD AVE STE 310
Practice Address - Street 2:
Practice Address - City:MISSOULA
Practice Address - State:MT
Practice Address - Zip Code:59801-7347
Practice Address - Country:US
Practice Address - Phone:406-543-5647
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-12-15
Last Update Date:2021-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT23461223P0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0700XDental ProvidersDentistProsthodontics