Individual
ANDREA M MYERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.D.S.
Contact information
Practice address
2200 OLYMPIC ST, SPRINGFIELD, OH 45503-2858
(937) 390-0493
Mailing address
2200 OLYMPIC ST, SPRINGFIELD, OH 45503-2858
(937) 390-0493
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
12011694A
IN
1223P0221X
Pediatric Dentistry
Primary
30023909
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0084707
—
OH
Enumeration date
07/13/2011
Last updated
04/21/2022
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