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General NPI Number Information
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NPI Number | 1760832471
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Entity Type | Individual
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Provider Name | YVONNE MELTON RDH
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Gender | Female
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Dates
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Enumeration Date | 06/14/2016
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Last Update Date | 06/14/2016
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Provider Practice Location Address
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Address Line | US ARMY DENTAL ACTIVITY BLDG 128 CHAFFEE ROAD ATTN: DENTAC HEADQUARETERS
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City | FT BLISS
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State | TX
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Zip | 79916
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Country | US
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Telephone | 915-742-6001
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Fax | 915-742-7462
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Provider Business Mailing Address
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Address Line | US ARMY DENTAL ACTIVITY BLDG 128 CHAFFEE ROAD ATTN: DENTAC HEADQUARETERS
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City | FT BLISS
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State | TX
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Zip | 79916
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Country | US
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Telephone | 915-742-6001
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Fax | 915-742-7462
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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 | 124Q00000X
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Taxonomy Name | Dental Hygienist
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License Number | 124Q00000X
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License Number State | TX
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