Provider Demographics
NPI:1932525250
Name:POHLSON, MEGAN (RDHAP)
Entity Type:Individual
Prefix:
First Name:MEGAN
Middle Name:
Last Name:POHLSON
Suffix:
Gender:F
Credentials:RDHAP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:531 BRENTWOOD DR
Mailing Address - Street 2:
Mailing Address - City:LEMOORE
Mailing Address - State:CA
Mailing Address - Zip Code:93245-4446
Mailing Address - Country:US
Mailing Address - Phone:559-707-7502
Mailing Address - Fax:
Practice Address - Street 1:531 BRENTWOOD DR
Practice Address - Street 2:
Practice Address - City:LEMOORE
Practice Address - State:CA
Practice Address - Zip Code:93245-4446
Practice Address - Country:US
Practice Address - Phone:559-707-7502
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-03-11
Last Update Date:2019-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA521124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist