Provider Demographics
NPI:1962927996
Name:GRAHAM, MEGHAN FOLEY (DMD)
Entity type:Individual
Prefix:DR
First Name:MEGHAN
Middle Name:FOLEY
Last Name:GRAHAM
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:MEGHAN
Other - Middle Name:KATHLEEN
Other - Last Name:FOLEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3 RESEARCH DR
Mailing Address - Street 2:
Mailing Address - City:WOODBRIDGE
Mailing Address - State:CT
Mailing Address - Zip Code:06525-2348
Mailing Address - Country:US
Mailing Address - Phone:203-745-8877
Mailing Address - Fax:
Practice Address - Street 1:123 YORK ST STE 4L
Practice Address - Street 2:
Practice Address - City:NEW HAVEN
Practice Address - State:CT
Practice Address - Zip Code:06511-5665
Practice Address - Country:US
Practice Address - Phone:203-781-8051
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-08-10
Last Update Date:2023-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT127191223X0400X
PADS0418571223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Multi-Specialty