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General NPI Number Information
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NPI Number | 1669816419
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Entity Type | Individual
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Provider Name | MEAGAN CHAFFINS STURM D.M.D.
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Gender | Female
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Dates
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Enumeration Date | 04/23/2013
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Last Update Date | 03/14/2016
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Provider Practice Location Address
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Address Line | 931 MONROE DR NE
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City | ATLANTA
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State | GA
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Zip | 30308-1793
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Country | US
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Telephone | 678-522-7130
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Fax |
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Provider Business Mailing Address
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Address Line | 3188 WINDSOR LAKE DR NE
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City | BROOKHAVEN
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State | GA
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Zip | 30319-2372
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Country | US
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Telephone | 678-522-7130
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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 | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | DN014905
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License Number State | GA
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