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General NPI Number Information
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NPI Number | 1336602291
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Entity Type | Organization
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Legal Business Name | DR ARCHIBALD L MELCHER IV LLC
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Dates
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Enumeration Date | 04/08/2019
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Last Update Date | 04/08/2019
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Provider Practice Location Address
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Address Line | 6367 JEFFERSON HWY
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City | HARAHAN
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State | LA
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Zip | 70123-5033
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Country | US
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Telephone | 504-737-5294
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Fax |
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Provider Business Mailing Address
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Address Line | 6367 JEFFERSON HWY
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City | HARAHAN
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State | LA
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Zip | 70123-5033
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Country | US
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Telephone | 504-737-5294
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. ARCHIBALD LOUIS MELCHER IV
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Credential | DDS
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Telephone | 504-756-0940
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number |
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License Number State |
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