Provider Demographics
NPI:1225566565
Name:MEGHAN TOLAND DMD, INC.
Entity Type:Organization
Organization Name:MEGHAN TOLAND DMD, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MEGHAN
Authorized Official - Middle Name:
Authorized Official - Last Name:TOLAND
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:978-852-0184
Mailing Address - Street 1:4116 KENDALL ST
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92109-5413
Mailing Address - Country:US
Mailing Address - Phone:978-852-0184
Mailing Address - Fax:
Practice Address - Street 1:8029 LA MESA BLVD
Practice Address - Street 2:
Practice Address - City:LA MESA
Practice Address - State:CA
Practice Address - Zip Code:91942-6434
Practice Address - Country:US
Practice Address - Phone:619-460-9100
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-05-31
Last Update Date:2017-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA62995261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental