| NPI | 1982178224 |
|---|---|
| Former Name | MEGAN FELLOWS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: OH 30.025618) |
| Enumeration Date | 2019-01-21 |
| Last Update Date | 2019-01-21 |