Individual
STEPHEN J MYERS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Contact information
Practice address
322 N MAIN ST, RANDOLPH, MA 02368-4151
(781) 963-4900
(781) 963-3911
Mailing address
322 N MAIN ST, RANDOLPH, MA 02368-4151
(781) 963-4900
(781) 963-3911
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
13660
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
X05360
BLUECROSSBLUESHIELD
MA
01
—
X11412
BLUECROSSBLUESHIELD
MA
Enumeration date
07/14/2006
Last updated
07/08/2007
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