Healthcare Provider Details

I. General information

NPI: 1528412772
Provider Name (Legal Business Name): MEGAN ELIZABETH HUYGHE DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/13/2016
Last Update Date: 11/20/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

434 N CENTER ST
NORTHVILLE MI
48167-1224
US

IV. Provider business mailing address

24070 MEADOWLARK ST
OAK PARK MI
48237-2277
US

V. Phone/Fax

Practice location:
  • Phone: 248-349-4111
  • Fax:
Mailing address:
  • Phone: 616-403-4892
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number2901021844
License Number StateMI
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: