Healthcare Provider Details

I. General information

NPI: 1891214409
Provider Name (Legal Business Name): MELANIE CHAPMAN LICENSED DENTURIST
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/14/2017
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

926 12TH ST
HOOD RIVER OR
97031-1538
US

IV. Provider business mailing address

926 12TH ST
HOOD RIVER OR
97031-1538
US

V. Phone/Fax

Practice location:
  • Phone: 541-386-2012
  • Fax: 541-387-2012
Mailing address:
  • Phone: 541-386-2012
  • Fax: 541-387-2012

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122400000X
TaxonomyDenturist
License NumberDT-DO-10179741
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: