MEDICARE: MEGAN MILBURN

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	122300000X	Dentist	9313	KY

General Provider Information

NPI Number	:	1518208396
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MEGAN MILBURN

Provider Business Mailing Address
First Line	:	326 W 6TH AVE
Second Line	:	APT 301
City	:	SPOKANE
State	:	WA
Zip	:	99204-2519
Country	:	US
Telephone Number	:	414-910-3151
Fax Number	:

Provider Business Practice Location Address
First Line	:	709 HOSPITAL LOOP
Second Line	:
City	:	FAIRCHILD AFB
State	:	WA
Zip	:	99011-8705
Country	:	US
Telephone Number	:	509-247-5820
Fax Number	:

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

Provider Enumeration Date	:	03/04/2013
Last Update Date	:	05/10/2016

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Directions to “ MEGAN MILBURN ” Practice Location

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