Healthcare Provider Details

I. General information

NPI: 1982948055
Provider Name (Legal Business Name): MELANIE WEBB BISHOP D.D.S.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/15/2012
Last Update Date: 11/15/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1478 MIDDLE TENNESSEE BLVD
MURFREESBORO TN
37130-5116
US

IV. Provider business mailing address

1478 MIDDLE TENNESSEE BLVD
MURFREESBORO TN
37130-5116
US

V. Phone/Fax

Practice location:
  • Phone: 615-893-9740
  • Fax:
Mailing address:
  • Phone: 615-893-9740
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License NumberDS005358
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: