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Organization
MELLON DENTAL MANAGEMENT, PLLC
Active
Organization
MELLON DENTAL MANAGEMENT, PLLC
Active
Other names
Tooth Scootin' Boogie
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RANDI MELLON DDS (DENTIST)
(830) 796-3548
Entity
Organization
Contact information
Practice address
584 STATE HIGHWAY 16 S, BANDERA, TX 78003-3808
(830) 796-3548
Mailing address
PO BOX 3612, BANDERA, TX 78003-6611
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
261QD0000X
Dental Clinic/Center
—
—
Other
Enumeration date
12/27/2022
Last updated
02/07/2023
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