Kenneth D. Meiss D.m.d. Ltd.

NPI #1790906139 in Peoria, Illinois

Provider Information

NPI Number: 1790906139
Entity Type: Organization
Organization Name: Kenneth D. Meiss D.m.d. Ltd.
Primary Specialty: Dentist - General Practice
Enumeration Date: May 2, 2007
Last Updated: Feb 20, 2015

Practice Location

Address: 910 W GLEN AVE
City: Peoria
State: Illinois
ZIP Code: 61614-4879
Phone: (309) 682-9802

Authorized Official

Name: DR. KENNETH DELAINE MEISS, D.M.D.
Title: PRESIDENT
Phone: (309) 682-9802

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist - General Practice — General Practice	1223G0001X	Primary

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