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General NPI Number Information
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NPI Number | 1306967161
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Entity Type | Individual
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Provider Name | MELISSA MOSELEY COLE DMD
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Gender | Female
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Dates
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Enumeration Date | 04/02/2007
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Last Update Date | 12/05/2007
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Provider Practice Location Address
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Address Line | 2614 HIGHWAY 49 S
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City | FLORENCE
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State | MS
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Zip | 39073-9415
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Country | US
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Telephone | 601-845-6357
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 185
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City | FLORENCE
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State | MS
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Zip | 39073-0185
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Country | US
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Telephone | 601-845-6357
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Fax |
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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 | 3334-05
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License Number State | MS
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