Provider Demographics
NPI:1487775318
Name:MYERS, SERE S JR (DDS)
Entity type:Individual
Prefix:
First Name:SERE
Middle Name:S
Last Name:MYERS
Suffix:JR
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 1:14100 E ARAPAHOE RD
Mailing Address - Street 2:STE # 310
Mailing Address - City:CENTENNIAL
Mailing Address - State:CO
Mailing Address - Zip Code:80112-4028
Mailing Address - Country:US
Mailing Address - Phone:303-699-5804
Mailing Address - Fax:303-680-2529
Practice Address - Street 1:14100 E ARAPAHOE RD
Practice Address - Street 2:STE. 310
Practice Address - City:CENTENNIAL
Practice Address - State:CO
Practice Address - Zip Code:80112-4028
Practice Address - Country:US
Practice Address - Phone:303-699-5804
Practice Address - Fax:303-680-2529
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO7433122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist