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General NPI Number Information
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NPI Number | 1821975525
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Entity Type | Individual
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Provider Name | MEGAN LU MELOCOTON DMD
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Gender | Female
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Dates
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Enumeration Date | 08/18/2025
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Last Update Date | 08/18/2025
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Provider Practice Location Address
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Address Line | 10590 ENDURING FREEDOM DR
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City | FORT DRUM
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State | NY
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Zip | 13602-5503
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Country | US
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Telephone | 315-772-8891
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Fax |
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Provider Business Mailing Address
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Address Line | 21450 REDWOOD LN APT F
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City | WATERTOWN
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State | NY
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Zip | 13601-6219
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Country | US
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Telephone | 702-285-4662
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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 | 122300000X
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Taxonomy Name | Dentist
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License Number | 14237738-9926
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License Number State | UT
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