MEDICARE: MELANIE A BACH DDS PLLC

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	261QD0000X	Dental Clinic/Center	0401410899	VA

General Provider Information

NPI Number	:	1730321118
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MELANIE A BACH DDS PLLC

Provider Business Mailing Address
First Line	:	10322 IRON BRIDGE RD
Second Line	:
City	:	CHESTER
State	:	VA
Zip	:	23831-1425
Country	:	US
Telephone Number	:	804-717-5400
Fax Number	:	804-717-5507

Provider Business Practice Location Address
First Line	:	10322 IRON BRIDGE RD
Second Line	:
City	:	CHESTER
State	:	VA
Zip	:	23831-1425
Country	:	US
Telephone Number	:	804-717-5400
Fax Number	:	804-717-5507

Authorized Official
Title or Position	:	OWNER/DENTIST
Name	:	MISS MELANIE ANN BACH
Credential	:	DDS
Telephone Number	:	804-717-5400

Provider Enumeration Date	:	03/31/2009
Last Update Date	:	03/31/2009

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