Individual
IVAN ANDREW MERICLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
2450 SUNSET POINT RD, CLEARWATER, FL 33765-1516
(727) 303-0600
Mailing address
12120 RUSTIC RIVER WAY, TAMPA, FL 33635-9534
(440) 225-9221
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
30-022572
OH
122300000X
Dentist
DN18906
FL
1223E0200X
Endodontics
Primary
DN18906
FL
Other
Enumeration date
01/17/2007
Last updated
05/14/2022
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