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General NPI Number Information
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NPI Number | 1467158741
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Entity Type | Individual
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Provider Name | MEGAN GULLEY RDH
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Gender | Female
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Dates
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Enumeration Date | 02/07/2023
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Last Update Date | 02/07/2023
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Provider Practice Location Address
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Address Line | 448 E 1ST ST STE 137
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City | SALIDA
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State | CO
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Zip | 81201-2867
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Country | US
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Telephone | 719-530-2570
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Fax |
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Provider Business Mailing Address
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Address Line | 10795 COUNTY ROAD 197A LOT 251
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City | NATHROP
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State | CO
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Zip | 81236-7741
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Country | US
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Telephone |
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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 | 124Q00000X
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Taxonomy Name | Dental Hygienist
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License Number | DH.002025243
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License Number State | CO
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