Provider Demographics
NPI:1669215109
Name:BAHNMILLER, MEGAN MARIE (DDS)
Entity type:Individual
Prefix:DR
First Name:MEGAN
Middle Name:MARIE
Last Name:BAHNMILLER
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 1:2211 SAHLSTROM DR STE A
Mailing Address - Street 2:
Mailing Address - City:CROOKSTON
Mailing Address - State:MN
Mailing Address - Zip Code:56716-2827
Mailing Address - Country:US
Mailing Address - Phone:218-281-1301
Mailing Address - Fax:
Practice Address - Street 1:2211 SAHLSTROM DR STE A
Practice Address - Street 2:
Practice Address - City:CROOKSTON
Practice Address - State:MN
Practice Address - Zip Code:56716-2827
Practice Address - Country:US
Practice Address - Phone:218-281-1301
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-13
Last Update Date:2024-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MND15098122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist