Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 122300000X | Dentist | DS039001 | PA |
Y | 1223S0112X | Oral and Maxillofacial Surgeon | DS039001 | PA |
N | 204E00000X | Oral & Maxillofacial Surgeon | DS039001 | PA |
N | 207L00000X | Anesthesiologist | DA031706 | PA |
NPI | 1366670556 |
---|---|
Provider Name | Dr. Meghan Deisroth Barroner |
First Address | Upper St Clair, PA 15241-3927 |
Second Address | Upper St Clair, PA 15241-3927 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 25/06/2009 |
Last Update Date | 05/10/2016 |