Provider Demographics
NPI:1760748941
Name:KINDER, MEGAN MARIE (DDS)
Entity Type:Individual
Prefix:DR
First Name:MEGAN
Middle Name:MARIE
Last Name:KINDER
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 1:1364 130TH AVE
Mailing Address - Street 2:
Mailing Address - City:NEW RICHMOND
Mailing Address - State:WI
Mailing Address - Zip Code:54017-6608
Mailing Address - Country:US
Mailing Address - Phone:612-381-6599
Mailing Address - Fax:
Practice Address - Street 1:400 2ND ST S
Practice Address - Street 2:#250
Practice Address - City:HUDSON
Practice Address - State:WI
Practice Address - Zip Code:54016-4000
Practice Address - Country:US
Practice Address - Phone:715-808-0460
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-04-02
Last Update Date:2012-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI6801-151223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry