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General NPI Number Information
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NPI Number | 1578091542
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Entity Type | Individual
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Provider Name | MEGHAN HARLEY DMD
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Gender | Female
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Dates
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Enumeration Date | 06/02/2017
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Last Update Date | 10/10/2024
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Provider Practice Location Address
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Address Line | 255 S 17TH ST STE 1806
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City | PHILADELPHIA
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State | PA
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Zip | 19103-6218
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Country | US
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Telephone | 215-735-1131
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Fax |
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Provider Business Mailing Address
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Address Line | 1601 FRANKFORD AVE # 3
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City | PHILADELPHIA
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State | PA
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Zip | 19125-4486
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Country | US
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Telephone | 551-404-2574
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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 | 1223E0200X
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Taxonomy Name | Endodontics
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License Number | DS042913
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License Number State | PA
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