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Organization
MARK D. MELLMAN, DDS. PA
Active
Organization
MARK D. MELLMAN, DDS. PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARK DAVID MELLMAN DDS (PRESIDENT)
(813) 654-4545
Entity
Organization
Contact information
Practice address
721 W ROBERTSON ST, SUITE 107, BRANDON, FL 33511-4934
(813) 654-4545
(813) 654-3470
Mailing address
721 W ROBERTSON ST, SUITE 107, BRANDON, FL 33511-4934
(813) 654-4545
(813) 654-3470
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
8712
FL
Other
Enumeration date
07/23/2006
Last updated
07/16/2008
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