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General NPI Number Information
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NPI Number | 1336391259
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Entity Type | Individual
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Provider Name | ANDREW J. MELCER D.M.D., M.P.H.
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Gender | Male
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Dates
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Enumeration Date | 10/22/2008
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Last Update Date | 08/28/2015
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Provider Practice Location Address
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Address Line | 1540 BEACON ST
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City | BROOKLINE
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State | MA
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Zip | 02446-2215
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Country | US
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Telephone | 617-738-1950
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Fax |
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Provider Business Mailing Address
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Address Line | 1540 BEACON ST
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City | BROOKLINE
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State | MA
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Zip | 02446-2215
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Country | US
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Telephone | 617-738-1950
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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 | 1223P0300X
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Taxonomy Name | Periodontics
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License Number | 13835
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License Number State | MA
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