Provider Demographics
NPI:1083918288
Name:HERD, MEGGAN JANE (DDS)
Entity Type:Individual
Prefix:DR
First Name:MEGGAN
Middle Name:JANE
Last Name:HERD
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 1:2650 CEDAR SPRINGS RD
Mailing Address - Street 2:UNIT 7706
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75201-1490
Mailing Address - Country:US
Mailing Address - Phone:619-549-4732
Mailing Address - Fax:
Practice Address - Street 1:5730 W LOVERS LN
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75209-5116
Practice Address - Country:US
Practice Address - Phone:214-352-0101
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-01-03
Last Update Date:2011-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX25688122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist