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General NPI Number Information
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NPI Number | 1437642303
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Entity Type | Individual
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Provider Name | MELISSA MACY DDS
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Gender | Female
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Dates
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Enumeration Date | 06/14/2018
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Last Update Date | 04/08/2019
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Provider Practice Location Address
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Address Line | 2860 S SENECA ST
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City | WICHITA
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State | KS
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Zip | 67217-2865
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Country | US
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Telephone | 316-522-4719
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Fax | 316-522-3398
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Provider Business Mailing Address
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Address Line | 2860 S SENECA ST
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City | WICHITA
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State | KS
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Zip | 67217-2865
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Country | US
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Telephone | 316-522-4719
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Fax | 316-522-3398
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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 | 61395
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License Number State | KS
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