Provider Demographics
NPI:1720278328
Name:MOYNEUR, MEGAN ELAINE (DDS)
Entity Type:Individual
Prefix:
First Name:MEGAN
Middle Name:ELAINE
Last Name:MOYNEUR
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 1:7210 GREENHAVEN DR
Mailing Address - Street 2:SUITE D
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95831-3576
Mailing Address - Country:US
Mailing Address - Phone:916-422-8680
Mailing Address - Fax:916-422-8690
Practice Address - Street 1:7210 GREENHAVEN DR
Practice Address - Street 2:SUITE D
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95831-3576
Practice Address - Country:US
Practice Address - Phone:916-422-8680
Practice Address - Fax:916-422-8690
Is Sole Proprietor?:No
Enumeration Date:2007-07-30
Last Update Date:2013-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA558911223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice