| NPI | 1366670556 |
|---|---|
| Former Name | MEGHAN DEISROTH BEERBOWER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: PA DS039001) |
| Additional Taxonomies | 122300000X Dentist (Licence: PA DS039001) |
| 207L00000X Anesthesiology (Licence: PA DA031706) | |
| 204E00000X Oral & Maxillofacial Surgery (Licence: PA DS039001) | |
| Enumeration Date | 2009-06-25 |
| Last Update Date | 2024-04-04 |