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Individual

DR. MELANIE BAUM

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
DMD

Contact information

Practice address
1197 E LOS ANGELES AVE, SIMI VALLEY, CA 93065-2868
(310) 600-2153
Mailing address
1203 ROSCOMARE RD, LOS ANGELES, CA 90077-2202
(310) 600-2153

Taxonomy

Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
056068
NY
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
62146
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
03474417
NY
Enumeration date
04/12/2011
Last updated
06/05/2019
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