Provider Demographics
NPI:1679887426
Name:BRUMMER, MEGAN E (DDS)
Entity type:Individual
Prefix:DR
First Name:MEGAN
Middle Name:E
Last Name:BRUMMER
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 1:922 RAINBOW DR
Mailing Address - Street 2:
Mailing Address - City:CEDAR FALLS
Mailing Address - State:IA
Mailing Address - Zip Code:50613-6500
Mailing Address - Country:US
Mailing Address - Phone:319-266-7559
Mailing Address - Fax:
Practice Address - Street 1:922 RAINBOW DR
Practice Address - Street 2:
Practice Address - City:CEDAR FALLS
Practice Address - State:IA
Practice Address - Zip Code:50613-6500
Practice Address - Country:US
Practice Address - Phone:319-266-7559
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-04
Last Update Date:2010-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA087581223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice