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General NPI Number Information
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NPI Number | 1073596185
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Entity Type | Individual
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Provider Name | MELANIE DE LEON DMD
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Gender | Female
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Dates
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Enumeration Date | 11/22/2005
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Last Update Date | 03/07/2023
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Provider Practice Location Address
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Address Line | 1717 LAS VEGAS ST
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City | MODESTO
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State | CA
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Zip | 95358-5500
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Country | US
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Telephone | 209-556-5044
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Fax | 209-566-5047
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Provider Business Mailing Address
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Address Line | 737 W CHILDS AVE
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City | MERCED
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State | CA
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Zip | 95340-6805
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Country | US
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Telephone | 209-383-1848
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Fax | 209-384-3966
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 41247
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License Number State | CA
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