Provider Demographics
NPI:1427105915
Name:MERCER DENTAL ASSOCIATES
Entity type:Organization
Organization Name:MERCER DENTAL ASSOCIATES
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DENTIST/ OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:ANDREW
Authorized Official - Last Name:MERCER
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:302-678-2942
Mailing Address - Street 1:77 SAULSBURY RD
Mailing Address - Street 2:
Mailing Address - City:DOVER
Mailing Address - State:DE
Mailing Address - Zip Code:19904
Mailing Address - Country:US
Mailing Address - Phone:302-678-2942
Mailing Address - Fax:302-678-2294
Practice Address - Street 1:77 SAULSBURY RD
Practice Address - Street 2:
Practice Address - City:DOVER
Practice Address - State:DE
Practice Address - Zip Code:19904-3444
Practice Address - Country:US
Practice Address - Phone:302-678-2942
Practice Address - Fax:302-678-2294
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-05
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEG1-0001116122300000X
DEG1-0001376122300000X
DEG1-0001155122300000X
DEG1-0001281122300000X
DEG1-0000801122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE1000037854Medicaid
DE1457747362OtherNPI
DE1932273216OtherNPI
DE1609940980OtherNPI
DE1841467586OtherNPI