Individual
MATTHEW MELLOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
116 N MAIN ST, COLFAX, WA 99111-1801
(509) 397-4077
Mailing address
621 HAWKESBURY TER, SILVER SPRING, MD 20904-6311
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DE 60573438
WA
Other
Enumeration date
08/07/2015
Last updated
08/07/2019
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