Individual
JACK ROBERT MEYER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
1934 YATES AVE, BRONX, NY 10461-1838
(718) 824-5540
Mailing address
1934 YATES AVE, BRONX, NY 10461-1838
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
029078
NY
Other
Enumeration date
10/14/2012
Last updated
10/14/2012
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