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General NPI Number Information
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NPI Number | 1598050015
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Entity Type | Organization
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Legal Business Name | DIR/NIDCR/NIH/DHHS
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Dates
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Enumeration Date | 06/13/2011
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Last Update Date | 06/13/2011
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Provider Practice Location Address
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Address Line | 10 CENTER DR BUILDING 10, ROOM 1N117
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City | BETHESDA
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State | MD
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Zip | 20892-0001
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Country | US
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Telephone | 301-443-8010
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Fax |
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Provider Business Mailing Address
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Address Line | 10 CENTER DR BUILDING 10, ROOM 1N117
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City | BETHESDA
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State | MD
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Zip | 20892-0001
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Country | US
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Telephone | 301-443-8010
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Fax |
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Authorized Official
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Title or Position | CLINICAL DIRECTOR
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Name | DR. JAMES MELVIN
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Credential | DDS, PHD
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Telephone | 301-402-1706
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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 |
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License Number State |
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