Individual
LISA A MELLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
92 FAUNCE CORNER RD UNIT 120, N DARTMOUTH, MA 02747-1262
(508) 997-1221
(508) 858-0622
Mailing address
92 FAUNCE CORNER RD UNIT 120, N DARTMOUTH, MA 02747-1262
(508) 997-1221
(508) 858-0622
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
DH10340
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
DH10340
MASS BOARD OF DENTISTRY
MA
Enumeration date
05/23/2011
Last updated
05/23/2011
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