# JERRY D MERRELL, DDS INC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1174008494
- **Authorized official:** DR. JERRY D MERRELL DDS, INC (PRESIDENT)
- **Authorized official phone:** (805) 688-1155

## Contact information

- **Practice address:** 2028 VILLAGE LN STE 101, SOLVANG, CA 93463-3222
- **Practice address phone:** (805) 688-1155
- **Practice address fax:** (805) 686-2699
- **Mailing address:** 2028 VILLAGE LN STE 101, SOLVANG, CA 93463-3222
- **Mailing address phone:** (805) 688-1155
- **Mailing address fax:** (805) 686-2699

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | — | NULL | Yes |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | — | — | Yes |

## Other

- **Enumeration date:** 10/02/2018
- **Last updated:** 12/21/2018