Provider Demographics
NPI:1427454388
Name:MEOLA & ASSOCIATES INC.
Entity type:Organization
Organization Name:MEOLA & ASSOCIATES INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DAMIAN
Authorized Official - Middle Name:
Authorized Official - Last Name:MEOLA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:781-860-0115
Mailing Address - Street 1:76 BEDFORD ST
Mailing Address - Street 2:UNIT 9
Mailing Address - City:LEXINGTON
Mailing Address - State:MA
Mailing Address - Zip Code:02420-4646
Mailing Address - Country:US
Mailing Address - Phone:781-860-0115
Mailing Address - Fax:781-860-5144
Practice Address - Street 1:76 BEDFORD ST
Practice Address - Street 2:UNIT 9
Practice Address - City:LEXINGTON
Practice Address - State:MA
Practice Address - Zip Code:02420-4646
Practice Address - Country:US
Practice Address - Phone:781-860-0115
Practice Address - Fax:781-860-5144
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-11-05
Last Update Date:2014-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA17511122300000X
MADN1856618122300000X
MADN216231223E0200X
MA217071223P0300X
MA209981223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty
No1223E0200XDental ProvidersDentistEndodonticsGroup - Multi-Specialty
No1223P0300XDental ProvidersDentistPeriodonticsGroup - Multi-Specialty
No1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Multi-Specialty