Healthcare Provider Details

I. General information

NPI: 1336454651
Provider Name (Legal Business Name): MEGHANN FAAS CLAUSSEN DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: MEGHANN MARIE FAAS DDS

II. Dates (important events)

Enumeration Date: 08/11/2010
Last Update Date: 05/01/2023
Certification Date: 05/01/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

403 E 11TH ST
PANAMA CITY FL
32401-3409
US

IV. Provider business mailing address

403 E 11TH ST
PANAMA CITY FL
32401-3409
US

V. Phone/Fax

Practice location:
  • Phone: 850-767-3350
  • Fax:
Mailing address:
  • Phone: 574-551-6031
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License NumberDN 19128
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: