Provider Demographics
NPI:1730292814
Name:MEAGLIA, ROBERT JAMES (DDS)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:JAMES
Last Name:MEAGLIA
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3111 SUNSET BLVD
Mailing Address - Street 2:SUITE X
Mailing Address - City:ROCKLIN
Mailing Address - State:CA
Mailing Address - Zip Code:95677
Mailing Address - Country:US
Mailing Address - Phone:916-624-0635
Mailing Address - Fax:916-624-0580
Practice Address - Street 1:3111 SUNSET BLVD
Practice Address - Street 2:SUITE X
Practice Address - City:ROCKLIN
Practice Address - State:CA
Practice Address - Zip Code:95677
Practice Address - Country:US
Practice Address - Phone:916-624-0635
Practice Address - Fax:916-624-0580
Is Sole Proprietor?:No
Enumeration Date:2006-08-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA24834122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist