Individual
MR. ISAAC ROBERT MEREDITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DT
Contact information
Practice address
1016 1ST ST S, WILLMAR, MN 56201-3510
(320) 235-2010
Mailing address
920 4TH ST SW, WILLMAR, MN 56201-3532
(612) 232-8958
Taxonomy
Speciality
Code
Description
License number
State
125J00000X
Dental Therapist
Primary
DT97
MN
Other
Enumeration date
01/18/2019
Last updated
01/18/2019
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