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Individual

DR. DANIEL EDMOND MYERS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.D.S

Contact information

Practice address
347 PARK AVE, PEWAUKEE, WI 53072-3413
(262) 691-1000
Mailing address
3113 FLEUR DE LIS DR, MEQUON, WI 53092-2302

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
5101-015
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
33753700
WI
Enumeration date
06/30/2006
Last updated
03/18/2013
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