Provider Demographics
NPI:1285719534
Name:MAYER, JOHN E (DDS)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:E
Last Name:MAYER
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13700 STATE RD
Mailing Address - Street 2:SUITE 9
Mailing Address - City:NORTH ROYALTON
Mailing Address - State:OH
Mailing Address - Zip Code:44133-3967
Mailing Address - Country:US
Mailing Address - Phone:440-237-0066
Mailing Address - Fax:
Practice Address - Street 1:13700 STATE RD
Practice Address - Street 2:SUITE 9
Practice Address - City:NORTH ROYALTON
Practice Address - State:OH
Practice Address - Zip Code:44133-3967
Practice Address - Country:US
Practice Address - Phone:440-237-0066
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH0156761223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice