Provider Demographics
NPI:1720413396
Name:HUYETT, MEGAN MCGILLICUDDY (DMD)
Entity Type:Individual
Prefix:DR
First Name:MEGAN
Middle Name:MCGILLICUDDY
Last Name:HUYETT
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:MEGAN
Other - Middle Name:A
Other - Last Name:MCGILLICUDDY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DMD
Mailing Address - Street 1:117 CHESTNUT ST
Mailing Address - Street 2:
Mailing Address - City:NEEDHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02492-2515
Mailing Address - Country:US
Mailing Address - Phone:781-444-3853
Mailing Address - Fax:
Practice Address - Street 1:117 CHESTNUT ST
Practice Address - Street 2:
Practice Address - City:NEEDHAM
Practice Address - State:MA
Practice Address - Zip Code:02492-2515
Practice Address - Country:US
Practice Address - Phone:781-444-3853
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-09-13
Last Update Date:2022-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
MADN1858211122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program