Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223D0001X | Dental Public Health | D11123 | OR |
NPI | 1740836238 |
---|---|
Provider Name | Dr. Megan Ashley Mclean |
First Address | Klamath Falls, OR 97601-8685 |
Second Address | Klamath Falls, OR 97601-3372 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/08/2019 |
Last Update Date | 12/08/2019 |