Provider Demographics
NPI:1174885131
Name:MEILING, CATHLEEN ANN (DDS)
Entity type:Individual
Prefix:DR
First Name:CATHLEEN
Middle Name:ANN
Last Name:MEILING
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:DR
Other - First Name:CATHLEEN
Other - Middle Name:ANN
Other - Last Name:RAZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DDS
Mailing Address - Street 1:419 E BROADWAY
Mailing Address - Street 2:
Mailing Address - City:WAUKESHA
Mailing Address - State:WI
Mailing Address - Zip Code:53186-5082
Mailing Address - Country:US
Mailing Address - Phone:262-549-6850
Mailing Address - Fax:
Practice Address - Street 1:419 E BROADWAY
Practice Address - Street 2:
Practice Address - City:WAUKESHA
Practice Address - State:WI
Practice Address - Zip Code:53186-5082
Practice Address - Country:US
Practice Address - Phone:262-549-6850
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-14
Last Update Date:2021-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI6917-151223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice