Provider Demographics
NPI:1174018709
Name:FREW, MEGAN MARIE (DMD)
Entity Type:Individual
Prefix:DR
First Name:MEGAN
Middle Name:MARIE
Last Name:FREW
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:613 BRIAR HILL RD
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40206-3011
Mailing Address - Country:US
Mailing Address - Phone:502-693-3003
Mailing Address - Fax:
Practice Address - Street 1:8251 CORNELL RD STE 130
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45249-2287
Practice Address - Country:US
Practice Address - Phone:513-621-7666
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-06-26
Last Update Date:2023-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY101611223G0001X
OH30.0259081223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice