Provider Demographics
NPI:1982261483
Name:POTEE, MEGHAN IRELAND (DDS)
Entity type:Individual
Prefix:DR
First Name:MEGHAN
Middle Name:IRELAND
Last Name:POTEE
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 1:1540 CONNER ST
Mailing Address - Street 2:
Mailing Address - City:NOBLESVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:46060-2914
Mailing Address - Country:US
Mailing Address - Phone:317-773-0883
Mailing Address - Fax:
Practice Address - Street 1:1540 CONNER ST
Practice Address - Street 2:
Practice Address - City:NOBLESVILLE
Practice Address - State:IN
Practice Address - Zip Code:46060-2914
Practice Address - Country:US
Practice Address - Phone:317-773-0883
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-05-21
Last Update Date:2019-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN12013152A1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice