Provider Demographics
NPI:1053487637
Name:STRUBY, MEAGAN (DDS)
Entity Type:Individual
Prefix:
First Name:MEAGAN
Middle Name:
Last Name:STRUBY
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1321 N MCCARRAN BLVD
Mailing Address - Street 2:104
Mailing Address - City:SPARKS
Mailing Address - State:NV
Mailing Address - Zip Code:89431-3879
Mailing Address - Country:US
Mailing Address - Phone:775-359-9300
Mailing Address - Fax:775-331-8503
Practice Address - Street 1:1321 N MCCARRAN BLVD
Practice Address - Street 2:104
Practice Address - City:SPARKS
Practice Address - State:NV
Practice Address - Zip Code:89431-3879
Practice Address - Country:US
Practice Address - Phone:775-359-9300
Practice Address - Fax:775-331-8503
Is Sole Proprietor?:No
Enumeration Date:2006-11-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVS3-741223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics