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General NPI Number Information
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NPI Number | 1730867813
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Entity Type | Organization
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Legal Business Name | MELISSA ENRIQUEZ
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Dates
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Enumeration Date | 07/07/2023
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Last Update Date | 07/07/2023
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Provider Practice Location Address
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Address Line | EPSILON 1823 MAGNAPLEX
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City | JUAREZ
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State | CHIHUAHUA
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Zip | 32410
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Country | MX
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Telephone | 619-272-9021
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Fax |
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Provider Business Mailing Address
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Address Line | 6070 GATEWAY BLVD E STE 106
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City | EL PASO
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State | TX
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Zip | 79905-2027
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Country | US
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Telephone | 619-272-9021
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Fax |
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Authorized Official
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Title or Position | DENTIST
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Name | MELISSA ENRIQUEZ
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Credential | DDS
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Telephone | 619-270-9021
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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 |
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License Number State |
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