Individual
MEGAN MCCORMACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
HYGIENTIST
Contact information
Practice address
101 WEST COAST RD, REDWAY, CA 95560
(707) 923-2783
Mailing address
PO BOX 1533, REDWAY, CA 95560-1533
(707) 923-4141
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
RDH 7642
CA
Other
Enumeration date
04/12/2007
Last updated
07/08/2007
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