Provider Demographics
NPI:1306970561
Name:MANSWELL, MEGAN A (DDS)
Entity type:Individual
Prefix:DR
First Name:MEGAN
Middle Name:A
Last Name:MANSWELL
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 1:7506 NEW HAMPSHIRE AVE
Mailing Address - Street 2:
Mailing Address - City:TAKOMA PARK
Mailing Address - State:MD
Mailing Address - Zip Code:20912-6905
Mailing Address - Country:US
Mailing Address - Phone:301-434-1230
Mailing Address - Fax:301-434-6838
Practice Address - Street 1:7506 NEW HAMPSHIRE AVE
Practice Address - Street 2:
Practice Address - City:TAKOMA PARK
Practice Address - State:MD
Practice Address - Zip Code:20912-6905
Practice Address - Country:US
Practice Address - Phone:301-434-1230
Practice Address - Fax:301-434-6838
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD112191223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice