Provider Demographics
NPI:1417395658
Name:SCARBOROUGH, MEAGAN LEE (DDS)
Entity Type:Individual
Prefix:MRS
First Name:MEAGAN
Middle Name:LEE
Last Name:SCARBOROUGH
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 1:2900 N QUINLAN PARK RD STE 160
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78732
Mailing Address - Country:US
Mailing Address - Phone:512-266-9585
Mailing Address - Fax:
Practice Address - Street 1:2900 N QUINLAN PARK RD STE 160
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78732
Practice Address - Country:US
Practice Address - Phone:512-266-9585
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-06-10
Last Update Date:2016-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX29040122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist