Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0221X | Pediatric Dentist | DN10347 | FL |
NPI | 1083892038 |
---|---|
Provider Name | Arthur Merkle |
First Address | Fort Walton Beach, FL 32548 |
Second Address | Fort Walton Beach, FL 32548 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/02/2008 |
Last Update Date | 01/02/2008 |