Individual
MICHAEL J MELDE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
2156 MCCULLOCH BLVD, #6, LAKE HAVASU CITY, AZ 86403
(928) 854-5551
(928) 854-5628
Mailing address
2156 MCCULLOCH BLVD, #6, LAKE HAVASU CITY, AZ 86403
(928) 854-5551
(928) 854-5628
Taxonomy
Speciality
Code
Description
License number
State
1223E0200X
Endodontics
Primary
3345
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
091885
AHCCCS
AZ
Enumeration date
02/13/2007
Last updated
07/08/2007
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