Provider Demographics
NPI:1972245876
Name:GINA MEYLAN DDS PLC
Entity type:Organization
Organization Name:GINA MEYLAN DDS PLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DDS
Authorized Official - Prefix:DR
Authorized Official - First Name:GINA
Authorized Official - Middle Name:
Authorized Official - Last Name:MEYLAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:989-792-1593
Mailing Address - Street 1:4933 MACKINAW RD
Mailing Address - Street 2:
Mailing Address - City:SAGINAW
Mailing Address - State:MI
Mailing Address - Zip Code:48603-7248
Mailing Address - Country:US
Mailing Address - Phone:989-792-1593
Mailing Address - Fax:989-792-6003
Practice Address - Street 1:4933 MACKINAW RD
Practice Address - Street 2:
Practice Address - City:SAGINAW
Practice Address - State:MI
Practice Address - Zip Code:48603-7248
Practice Address - Country:US
Practice Address - Phone:989-792-1593
Practice Address - Fax:989-792-6003
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-04-11
Last Update Date:2022-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental