Nicholas Merica, DMD

Individual provider Active NPI General Practice Dentistry · Cabool, MO

NPI 1831540780 · NPPES record last updated Jun 22, 2016

Key facts

NPI
1831540780
Entity type
Individual (NPI type 1)
Primary specialty
General Practice Dentistry 1223G0001X
License
2016021051 (MO)
Practice address
530 Spruce Ave
Cabool, MO 65689-9712
Phone
(417) 962-3150
Fax
(417) 962-5839
NPI assigned
Jun 22, 2016
Sex
Male
Sole proprietor
No

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
2016021051MOMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Merica Family Dental Current
since Oct 10, 2021
Accepting new patients
Cartwright, DMD & Dolenz, DDS, PC General Practice Past Accepting new patients

Locations

530 Spruce Ave
Cabool, MO 65689
Phone (417) 962-3150

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 2016021051 MO Yes

Addresses

Primary practice location

530 Spruce Ave
Cabool, MO 65689-9712

Mailing address

PO Box 920
Cabool, MO 65689
Phone (417) 962-3150

Other providers in Cabool, MO

All providers in Cabool, MO · General Practice Dentistry in Missouri

Sources for this page

Verify at the official NPI Registry.