Provider Demographics
NPI:1669814166
Name:MCCONE, MEGGAN LOUISE-KRAUSE (DDS)
Entity Type:Individual
Prefix:DR
First Name:MEGGAN
Middle Name:LOUISE-KRAUSE
Last Name:MCCONE
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:DR
Other - First Name:MEGGAN
Other - Middle Name:LOUISE
Other - Last Name:KRAUSE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DDS
Mailing Address - Street 1:1750 GRAND RIDGE CT NE
Mailing Address - Street 2:SUITE 202
Mailing Address - City:GRAND RAPIDS
Mailing Address - State:MI
Mailing Address - Zip Code:49525
Mailing Address - Country:US
Mailing Address - Phone:616-988-9485
Mailing Address - Fax:616-988-9486
Practice Address - Street 1:1750 GRAND RIDGE CT NE
Practice Address - Street 2:SUITE 202
Practice Address - City:GRAND RAPIDS
Practice Address - State:MI
Practice Address - Zip Code:49525
Practice Address - Country:US
Practice Address - Phone:616-988-9485
Practice Address - Fax:616-988-9486
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-24
Last Update Date:2017-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI29010204731223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry