# MELE FAMILY DENTISTRY PC

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

## Provider details

- **NPI number:** 1992303945
- **Authorized official:** COREY MELE DMD (PRESIDENT)
- **Authorized official phone:** (215) 520-5051

## Contact information

- **Practice address:** 40 W EVERGREEN AVE STE 111, PHILADELPHIA, PA 19118-3324
- **Practice address phone:** (215) 242-9411
- **Practice address fax:** (215) 242-3454
- **Mailing address:** 40 W EVERGREEN AVE STE 111, PHILADELPHIA, PA 19118-3324
- **Mailing address phone:** (215) 242-9411
- **Mailing address fax:** (215) 242-3454

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | — | NULL | Yes |
| 1223G0001X | General Practice Dentistry | — | — | Yes |
| 1223P0300X | Periodontics | — | NULL | — |
| 1223P0300X | Periodontics | — | — | — |

## Other

- **Enumeration date:** 10/13/2020
- **Last updated:** 10/13/2020