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NPI 1992805451

NPI 1992805451 : MELISSA A NAIDYHORSKI DDS : CHANHASSEN, MN

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General NPI Number Information
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    NPI Number           |    1992805451
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    Entity Type          |    Individual 
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    Provider Name        |    MELISSA A NAIDYHORSKI DDS
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    09/25/2006
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    Last Update Date     |    07/08/2007
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Provider Practice Location Address
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    Address Line         |    7806 MARKET BLVD METRO DENTAL CARE
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    City                 |    CHANHASSEN
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    State                |    MN
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    Zip                  |    55317
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    Country              |    US
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    Telephone            |    952-949-1083
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    Fax                  |    952-949-1084
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Provider Business Mailing Address
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    Address Line         |    PO BOX 23029 METRO DENTAL CARE
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    City                 |    RICHFIELD
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    State                |    MN
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    Zip                  |    55423
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    Country              |    US
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    Telephone            |    952-949-1083
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    Fax                  |    952-949-1084
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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       |    D12247
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    License Number State |    MN
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