Provider Demographics
NPI:1306950324
Name:MEISNER, NORMAN ERIC (DDS)
Entity type:Individual
Prefix:
First Name:NORMAN
Middle Name:ERIC
Last Name:MEISNER
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 1:225 FAIRVIEW AVE
Mailing Address - Street 2:
Mailing Address - City:HUDSON
Mailing Address - State:NY
Mailing Address - Zip Code:12534-1207
Mailing Address - Country:US
Mailing Address - Phone:518-828-1110
Mailing Address - Fax:518-828-1110
Practice Address - Street 1:225 FAIRVIEW AVE
Practice Address - Street 2:
Practice Address - City:HUDSON
Practice Address - State:NY
Practice Address - Zip Code:12534-1207
Practice Address - Country:US
Practice Address - Phone:518-828-1110
Practice Address - Fax:518-828-1110
Is Sole Proprietor?:No
Enumeration Date:2006-08-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY035075122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00706107Medicare ID - Type Unspecified