# MELISSA C. DAVIDIAN, DDS/DAVIDIAN FAMILY AND COSMETIC DENTISTRY

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1578720892
- **Authorized official:** DR. MELISSA C. DAVIDIAN DDS (DENTIST, OWNER)
- **Authorized official phone:** (919) 562-2345

## Contact information

- **Practice address:** 12740 SPRUCE TREE WAY, SUITE 104, RALEIGH, NC 27614-8295
- **Practice address phone:** (919) 562-2345
- **Practice address fax:** (919) 562-2365
- **Mailing address:** 12740 SPRUCE TREE WAY, SUITE 104, RALEIGH, NC 27614-8295
- **Mailing address phone:** (919) 562-2345
- **Mailing address fax:** (919) 562-2365

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | 7060 | NC | Yes |

## Other

- **Enumeration date:** 05/22/2008
- **Last updated:** 05/22/2008

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 1215088133 | INDIVIDUAL IPN \# | NC |