Provider Demographics
NPI:1194739649
Name:MEYER, ROBERT B (DDS, MS)
Entity type:Individual
Prefix:
First Name:ROBERT
Middle Name:B
Last Name:MEYER
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 1:1815 KILDAIRE FARM RD STE C
Mailing Address - Street 2:
Mailing Address - City:CARY
Mailing Address - State:NC
Mailing Address - Zip Code:27511-6562
Mailing Address - Country:US
Mailing Address - Phone:919-852-0009
Mailing Address - Fax:
Practice Address - Street 1:1815 KILDAIRE FARM RD STE C
Practice Address - Street 2:
Practice Address - City:CARY
Practice Address - State:NC
Practice Address - Zip Code:27511-6562
Practice Address - Country:US
Practice Address - Phone:919-852-0009
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC53641223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics