Nicholas Ryan Mellum DMD

NPI 1053454173 - Dentist - 1223G0001X

NPI Details
NPI 1053454173
Gender Male
Enumeration Date 02/15/2007
Last Updated 07/08/2007
Entity Type Individual
Active Over 9 years ago
Practice Location
8910 N KELLOGG ST
PORTLAND OR, 97203-3002, US
Phone (503) 286-4492
Fax
Business Location
4435 NW NESKOWIN AVE
PORTLAND OR, 97229-2803, US
Phone (503) 998-9450
Fax
Toxanomy
Taxonomy Code 1223G0001X
License State Oregon
License Number D8836
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According to our database, Dr. Nicholas Ryan Mellum DMD NPI is 1053454173, taxonomy code is 1223G0001X and license number is D8836, license state is located at Oregon. Nicholas Ryan Mellum DMD physically located at 8910 N Kellogg St, Portland OR, 97203-3002. NPI Number Nicholas Ryan Mellum DMD has the Individual type.

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1053454173 NPI number is provided on an as is basis without warranty of any kind. 1053454173 is maintained by the National Plan & Provider Enumeration System. The contents of Nicholas Ryan Mellum DMD are for informational purposes only.