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General NPI Number Information
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NPI Number | 1407415250
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Entity Type | Individual
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Provider Name | RICARDO ULISES MELCHOR DDS
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Gender | Male
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Dates
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Enumeration Date | 06/06/2019
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Last Update Date | 04/25/2024
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Provider Practice Location Address
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Address Line | 2221 MAPLE AVE
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City | BURLINGTON
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State | NC
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Zip | 27215-7144
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Country | US
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Telephone | 336-338-5851
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Fax |
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Provider Business Mailing Address
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Address Line | 5305 FIELDBROOK DR
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City | GREENSBORO
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State | NC
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Zip | 27455-1121
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Country | US
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Telephone | 505-710-2907
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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 | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 12667
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 019.032161
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License Number State | IL
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