MEDICARE: DR. MELANIE APOSTLE KOEHLER DDS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	44717	CA

General Provider Information

NPI Number	:	1265538334
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MELANIE APOSTLE KOEHLER DDS

Provider Business Mailing Address
First Line	:	901 SAN RAMON VALLEY BLVD
Second Line	:	SUITE 230
City	:	DANVILLE
State	:	CA
Zip	:	94526-4034
Country	:	US
Telephone Number	:	925-820-1044
Fax Number	:	925-820-3227

Provider Business Practice Location Address
First Line	:	901 SAN RAMON VALLEY BLVD
Second Line	:	SUITE 230
City	:	DANVILLE
State	:	CA
Zip	:	94526-4034
Country	:	US
Telephone Number	:	925-820-1044
Fax Number	:	925-820-3227

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/16/2006
Last Update Date	:	07/08/2007

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