MEDICARE: MEGHAN WILHELMI D.M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223P0221X	Pediatric Dentistry	DN1856873	MA

General Provider Information

NPI Number	:	1386066454
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MEGHAN WILHELMI D.M.D.

Provider Business Mailing Address
First Line	:	67 MONTVALE AVE
Second Line	:	STE. 101
City	:	STONEHAM
State	:	MA
Zip	:	02180-3618
Country	:	US
Telephone Number	:	781-279-2400
Fax Number	:	781-279-4640

Provider Business Practice Location Address
First Line	:	67 MONTVALE AVE
Second Line	:	STE. 101
City	:	STONEHAM
State	:	MA
Zip	:	02180-3618
Country	:	US
Telephone Number	:	781-279-2400
Fax Number	:	781-279-4640

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/09/2014
Last Update Date	:	02/07/2017

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