Nick R. Mellum Dmd Pc

NPI 1013281484 - Dentist - 1223G0001X

NPI Details
NPI 1013281484
Enumeration Date 03/02/2012
Last Updated 03/02/2012
Entity Type Healthcare Provider
Active Over 4 years ago
Authorized Information
Name NICK NICK
Position DENTIST
Phone (503) 286-4492
Fax
Practice Location
8910 N KELLOGG ST
PORTLAND OR, 97203-3002, US
Phone (503) 286-4492
Fax
Business Location
8910 N KELLOGG ST
PORTLAND OR, 97203-3002, US
Phone
Fax
Toxanomy
Taxonomy Code 1223G0001X
License State Oregon
License Number D8836
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According to our database, Nick R. Mellum Dmd Pc NPI is 1013281484, taxonomy code is 1223G0001X and license number is D8836, license state is located at Oregon. Nick R. Mellum Dmd Pc physically located at 8910 N Kellogg St, Portland OR, 97203-3002. NPI Number 1033115704 has the healthcare provider type.

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1013281484 NPI number is provided on an as is basis without warranty of any kind. 1013281484 is maintained by the National Plan & Provider Enumeration System. The contents of Nick R. Mellum Dmd Pc are for informational purposes only.