Provider Demographics
NPI:1194704528
Name:MERIDIAN DENTAL ASSOCIATES
Entity type:Organization
Organization Name:MERIDIAN DENTAL ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:RONALD
Authorized Official - Middle Name:D
Authorized Official - Last Name:PERRY
Authorized Official - Suffix:
Authorized Official - Credentials:DMD MS
Authorized Official - Phone:781-331-9200
Mailing Address - Street 1:1650 MAIN STREET
Mailing Address - Street 2:
Mailing Address - City:S WEYMOUTH
Mailing Address - State:MA
Mailing Address - Zip Code:02190
Mailing Address - Country:US
Mailing Address - Phone:781-331-9200
Mailing Address - Fax:781-331-9380
Practice Address - Street 1:1650 MAIN STREET
Practice Address - Street 2:MERIDIAN DENTAL ASSOCIATES
Practice Address - City:S WEYMOUTH
Practice Address - State:MA
Practice Address - Zip Code:02190
Practice Address - Country:US
Practice Address - Phone:781-331-9200
Practice Address - Fax:781-331-9380
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-13
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA173511223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty