Provider Demographics
NPI:1811620594
Name:MEGAN VERGARA, RDHAP, A PROFESSIONAL CORPORATION
Entity Type:Organization
Organization Name:MEGAN VERGARA, RDHAP, A PROFESSIONAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MEGAN
Authorized Official - Middle Name:
Authorized Official - Last Name:VERGARA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:530-680-4290
Mailing Address - Street 1:704 CREEKSIDE CT
Mailing Address - Street 2:
Mailing Address - City:ROSEVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95678-4303
Mailing Address - Country:US
Mailing Address - Phone:530-680-4290
Mailing Address - Fax:
Practice Address - Street 1:704 CREEKSIDE CT
Practice Address - Street 2:
Practice Address - City:ROSEVILLE
Practice Address - State:CA
Practice Address - Zip Code:95678-4303
Practice Address - Country:US
Practice Address - Phone:153-068-0429
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-07-08
Last Update Date:2022-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes124Q00000XDental ProvidersDental HygienistGroup - Single Specialty