Individual
ETHAN GLENN MEIER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2160 S 1ST AVE, MAYWOOD, IL 60153-3328
(888) 584-7888
Mailing address
2160 S 1ST AVE, MAYWOOD, IL 60153-3328
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
019.035078
IL
Other
Enumeration date
03/15/2024
Last updated
05/25/2024
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