Provider Demographics
NPI:1043726250
Name:MEGAN M. RAYNOR, DMD, PLLC
Entity Type:Organization
Organization Name:MEGAN M. RAYNOR, DMD, PLLC
Other - Org Name:MEGAN M. RAYNOR, DMD, PLLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DENTIST/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MEGAN
Authorized Official - Middle Name:MORSE
Authorized Official - Last Name:RAYNOR
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:704-516-7191
Mailing Address - Street 1:5500 HIGHWAY 49 SOUTH
Mailing Address - Street 2:SUITE 100
Mailing Address - City:HARRISBURG
Mailing Address - State:NC
Mailing Address - Zip Code:28075
Mailing Address - Country:US
Mailing Address - Phone:704-455-2177
Mailing Address - Fax:704-455-3816
Practice Address - Street 1:5500 HIGHWAY 49 SOUTH
Practice Address - Street 2:SUITE 100
Practice Address - City:HARRISBURG
Practice Address - State:NC
Practice Address - Zip Code:28075
Practice Address - Country:US
Practice Address - Phone:704-455-2177
Practice Address - Fax:704-455-3816
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-12-26
Last Update Date:2017-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC10376261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC1699125393OtherNPPES