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General NPI Number Information
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NPI Number | 1972689297
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Entity Type | Organization
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Legal Business Name | MELVYN E. NATHANSON, DDS, PA
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Dates
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Enumeration Date | 10/29/2006
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Last Update Date | 05/21/2020
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Provider Practice Location Address
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Address Line | 11484 OHANU CIR
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City | BOYNTON BEACH
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State | FL
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Zip | 33437-7031
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Country | US
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Telephone | 561-733-9662
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Fax |
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Provider Business Mailing Address
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Address Line | 11484 OHANU CIR
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City | BOYNTON BEACH
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State | FL
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Zip | 33437-7031
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Country | US
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Telephone | 561-733-9662
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. MELVYN E NATHANSON
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Credential | DDS
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Telephone | 561-733-9662
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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 | 008234
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License Number State | FL
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