Healthcare Provider Details

I. General information

NPI: 1235250028
Provider Name (Legal Business Name): MELANIE R FORRISTER DDS,MS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/02/2007
Last Update Date: 07/09/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4396 E US HIGHWAY 64
MURPHY NC
28906-7912
US

IV. Provider business mailing address

4396 E US HIGHWAY 64
MURPHY NC
28906-7912
US

V. Phone/Fax

Practice location:
  • Phone: 828-835-3128
  • Fax: 828-835-8101
Mailing address:
  • Phone: 828-835-3128
  • Fax: 828-835-8101

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223X0400X
TaxonomyOrthodontics and Dentofacial Orthopedics Dentistry
License Number6137
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: