Individual
DR. MARK M MEREDITH JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
8066 HWY 165, COLUMBIA, LA 71418
(318) 649-6161
(318) 649-6161
Mailing address
PO BOX 360, COLUMBIA, LA 71418-0360
(318) 649-6161
(318) 649-6161
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
5975
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1859753
—
LA
Enumeration date
06/16/2009
Last updated
07/22/2022
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