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General NPI Number Information
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NPI Number | 1467061689
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Entity Type | Individual
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Provider Name | MEGAN EFFNER
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Gender | Female
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Dates
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Enumeration Date | 07/23/2020
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Last Update Date | 11/14/2023
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Provider Practice Location Address
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Address Line | 10750 W MCDOWELL RD STE F610
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City | AVONDALE
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State | AZ
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Zip | 85392-5976
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Country | US
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Telephone | 480-581-9591
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Fax |
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Provider Business Mailing Address
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Address Line | 4760 E BASELINE RD APT 3050
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City | MESA
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State | AZ
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Zip | 85206-4694
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Country | US
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Telephone | 331-330-5440
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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 | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | D011914
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License Number State | AZ
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