Provider Demographics
NPI:1336344837
Name:ANDERSON NEUBERGER, MEAGHAN ANNETTE (DDS)
Entity Type:Individual
Prefix:
First Name:MEAGHAN
Middle Name:ANNETTE
Last Name:ANDERSON NEUBERGER
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:MEAGHAN
Other - Middle Name:
Other - Last Name:NEUBERGER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:7712 W REGINA ST
Mailing Address - Street 2:
Mailing Address - City:SIOUX FALLS
Mailing Address - State:SD
Mailing Address - Zip Code:57106-4707
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3610 S WESTERN AVE
Practice Address - Street 2:
Practice Address - City:SIOUX FALLS
Practice Address - State:SD
Practice Address - Zip Code:57105-6142
Practice Address - Country:US
Practice Address - Phone:605-339-4050
Practice Address - Fax:605-339-4240
Is Sole Proprietor?:No
Enumeration Date:2007-06-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SDD06381223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice