Provider Demographics
NPI:1285055350
Name:COURTNEY S. MEYER, D.D.S., L.L.C.
Entity type:Organization
Organization Name:COURTNEY S. MEYER, D.D.S., L.L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER OF DENTAL PRACTICE
Authorized Official - Prefix:DR
Authorized Official - First Name:COURTNEY
Authorized Official - Middle Name:SARRETT
Authorized Official - Last Name:MEYER
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:712-362-5454
Mailing Address - Street 1:808 N 9TH ST
Mailing Address - Street 2:
Mailing Address - City:ESTHERVILLE
Mailing Address - State:IA
Mailing Address - Zip Code:51334-1534
Mailing Address - Country:US
Mailing Address - Phone:712-362-5454
Mailing Address - Fax:712-362-4737
Practice Address - Street 1:808 N 9TH ST
Practice Address - Street 2:
Practice Address - City:ESTHERVILLE
Practice Address - State:IA
Practice Address - Zip Code:51334-1534
Practice Address - Country:US
Practice Address - Phone:712-362-5454
Practice Address - Fax:712-362-4737
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-12-17
Last Update Date:2013-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty