Provider Demographics
NPI:1245610427
Name:DICOSTANZO, MEGAN E (DMD)
Entity Type:Individual
Prefix:
First Name:MEGAN
Middle Name:E
Last Name:DICOSTANZO
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:MEGAN
Other - Middle Name:E
Other - Last Name:BUHLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DMD
Mailing Address - Street 1:106 HIDDEN VALLEY CT
Mailing Address - Street 2:
Mailing Address - City:SEWICKLEY
Mailing Address - State:PA
Mailing Address - Zip Code:15143-9381
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1009 BEAVER GRADE RD STE 300
Practice Address - Street 2:
Practice Address - City:CORAOPOLIS
Practice Address - State:PA
Practice Address - Zip Code:15108-2969
Practice Address - Country:US
Practice Address - Phone:412-264-6229
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-06-03
Last Update Date:2023-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS040445122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist