MEDICARE: DR. JAMES R MEGAHAN D.D.S.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	13224	MI

General Provider Information

NPI Number	:	1407913452
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JAMES R MEGAHAN D.D.S.

Provider Business Mailing Address
First Line	:	2550 MUNSTER RD
Second Line	:
City	:	ROCHESTER HILLS
State	:	MI
Zip	:	48309-2322
Country	:	US
Telephone Number	:	248-375-0967
Fax Number	:	248-652-2305

Provider Business Practice Location Address
First Line	:	4450 COLLINS RD
Second Line	:
City	:	ROCHESTER
State	:	MI
Zip	:	48306-1620
Country	:	US
Telephone Number	:	248-652-3663
Fax Number	:	248-652-2305

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/02/2007
Last Update Date	:	07/08/2007

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