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General NPI Number Information
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NPI Number | 1275784605
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Entity Type | Individual
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Provider Name | MEGAN JOANN DIAZ-FREED DDS
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Gender | Female
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Dates
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Enumeration Date | 10/03/2008
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Last Update Date | 10/03/2008
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Provider Practice Location Address
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Address Line | 205 S WEBSTER ST
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City | CALMAR
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State | IA
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Zip | 52132-0818
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Country | US
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Telephone | 563-562-9034
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Fax |
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Provider Business Mailing Address
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Address Line | PSC 557 BOX 1336
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City | FPO
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State | AP
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Zip | 96379-0379
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Country | US
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Telephone | 08033146578
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 08588
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License Number State | IA
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