Provider Demographics
NPI:1639928617
Name:HANKS, MEGAN CHRISTINE (RDH, EPP EPDH)
Entity type:Individual
Prefix:MISS
First Name:MEGAN
Middle Name:CHRISTINE
Last Name:HANKS
Suffix:
Gender:F
Credentials:RDH, EPP EPDH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:876 S 69TH PLACE
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:OR
Mailing Address - Zip Code:97478
Mailing Address - Country:US
Mailing Address - Phone:919-592-9591
Mailing Address - Fax:
Practice Address - Street 1:1045 GATEWAY LOOP
Practice Address - Street 2:
Practice Address - City:SPRINFIELD
Practice Address - State:OR
Practice Address - Zip Code:97477
Practice Address - Country:US
Practice Address - Phone:541-632-2123
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-14
Last Update Date:2024-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORH7845124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist