Provider Demographics
NPI:1386172997
Name:MCCAULEY, MEAGHAN C (DMD)
Entity type:Individual
Prefix:DR
First Name:MEAGHAN
Middle Name:C
Last Name:MCCAULEY
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:DR
Other - First Name:MEAGHAN
Other - Middle Name:C
Other - Last Name:MACRI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DMD
Mailing Address - Street 1:185 PROVIDENCE ST UNIT A419
Mailing Address - Street 2:
Mailing Address - City:WEST WARWICK
Mailing Address - State:RI
Mailing Address - Zip Code:02893-2581
Mailing Address - Country:US
Mailing Address - Phone:978-394-0596
Mailing Address - Fax:
Practice Address - Street 1:81 DANIELSON PIKE
Practice Address - Street 2:
Practice Address - City:NORTH SCITUATE
Practice Address - State:RI
Practice Address - Zip Code:02857-1892
Practice Address - Country:US
Practice Address - Phone:401-647-5640
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-05-25
Last Update Date:2018-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIDEN034081223G0001X
MAS31768002390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program