Individual
DR. MARK W MERIDETH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
1390 W CHEROKEE ST, CLEVELAND, OK 74020-4044
(918) 358-2300
(918) 358-2302
Mailing address
1390 W CHEROKEE ST, CLEVELAND, OK 74020-4044
(918) 358-2300
(918) 358-2302
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
5807
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200062770A
—
OK
Enumeration date
01/10/2007
Last updated
07/17/2012
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