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General NPI Number Information
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NPI Number | 1770171167
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Entity Type | Individual
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Provider Name | MEGAN ANN SCHENCK
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Gender | Female
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Dates
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Enumeration Date | 01/02/2021
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Last Update Date | 01/02/2021
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Provider Practice Location Address
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Address Line | 12273 EMERALD COAST PKWY W STE 117
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City | MIRAMAR BEACH
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State | FL
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Zip | 32550-6945
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Country | US
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Telephone | 386-623-0569
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Fax |
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Provider Business Mailing Address
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Address Line | 409 FIR AVE
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City | NICEVILLE
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State | FL
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Zip | 32578-1327
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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 | DH23796
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License Number State | FL
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