Organization
INTREPID INNOVATIONS LLC
Active
Other names
Bona Fide Hygiene Care
Organization subpart
No
Provider details
NPI number
Authorized official
MEGAN HANKS EPDH (DENTAL HYGIENIST)
(919) 592-9591
Entity
Organization
Contact information
Practice address
1045 GATEWAY LOOP STE F, SPRINGFIELD, OR 97477-1128
(541) 632-2123
Mailing address
876 S 69TH PL, SPRINGFIELD, OR 97478-7315
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
10/18/2024
Last updated
10/18/2024
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