MEDICARE: MELANIE ANDREWS 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	3800	LA

General Provider Information

NPI Number	:	1447253430
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MELANIE ANDREWS DDS

Provider Business Mailing Address
First Line	:	103 PLANTATION ROAD
Second Line	:
City	:	DESTREHAN
State	:	LA
Zip	:	70047-3811
Country	:	US
Telephone Number	:	985-764-1148
Fax Number	:	985-725-1877

Provider Business Practice Location Address
First Line	:	103 PLANTATION RD
Second Line	:
City	:	DESTREHAN
State	:	LA
Zip	:	70047-3016
Country	:	US
Telephone Number	:	985-764-1148
Fax Number	:	985-725-1877

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

Provider Enumeration Date	:	05/23/2005
Last Update Date	:	03/22/2011

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