Provider Demographics
NPI:1871116673
Name:MYERS, CHELSEA ANN (DDS)
Entity type:Individual
Prefix:DR
First Name:CHELSEA
Middle Name:ANN
Last Name:MYERS
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:50745 WILTON ST
Mailing Address - Street 2:
Mailing Address - City:NEW BALTIMORE
Mailing Address - State:MI
Mailing Address - Zip Code:48047-4275
Mailing Address - Country:US
Mailing Address - Phone:586-321-7751
Mailing Address - Fax:
Practice Address - Street 1:50503 GRATIOT AVE
Practice Address - Street 2:
Practice Address - City:CHESTERFIELD
Practice Address - State:MI
Practice Address - Zip Code:48051-3184
Practice Address - Country:US
Practice Address - Phone:586-273-6120
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-05-27
Last Update Date:2021-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI29016008681223G0001X
IN12013351A1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice