Megan McCormack, HYGIENTIST

Individual provider Active NPI Dental Hygienist · Redway, CA

NPI 1124242888 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1124242888
Entity type
Individual (NPI type 1)
Primary specialty
Dental Hygienist 124Q00000X
License
RDH 7642 (CA)
Practice address
101 West Coast Rd
Redway, CA 95560
Phone
(707) 923-2783
NPI assigned
Apr 12, 2007
Sex
Female
Sole proprietor
No

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
RDH 7642CAMDDental Hygienist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Hygienist 124Q00000X RDH 7642 CA Yes

Addresses

Primary practice location

101 West Coast Rd
Redway, CA 95560

Mailing address

PO Box 1533
Redway, CA 95560-1533
Phone (707) 923-4141

Other providers in Redway, CA

All providers in Redway, CA · Dental Hygienist in California

Sources for this page

Verify at the official NPI Registry.