# MERIT DENTAL INC.

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

## Provider details

- **NPI number:** 1487166799
- **Authorized official:** DIANE MARIE BRION-MARTIN (CREDENTIALING TEAM LEAD)
- **Authorized official phone:** (715) 598-2311

## Contact information

- **Practice address:** 128 W OAK ST, FRACKVILLE, PA 17931-1718
- **Practice address phone:** (570) 874-1954
- **Practice address fax:** (570) 874-0433
- **Mailing address:** 680 HEHLI WAY, MONDOVI, WI 54755-1639
- **Mailing address phone:** (715) 598-2311
- **Mailing address fax:** (715) 350-6855

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | 3139 | WI | Yes |

## Other

- **Enumeration date:** 10/26/2017
- **Last updated:** 10/26/2017