Organization
MARK D. MELLMAN, DDS. PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARK DAVID MELLMAN DDS (PRESIDENT)
(813) 654-4545
Entity
Organization
Contact information
Practice address
721 W ROBERTSON ST, SUITE 107, BRANDON, FL 33511-4934
(813) 654-4545
(813) 654-3470
Mailing address
721 W ROBERTSON ST, SUITE 107, BRANDON, FL 33511-4934
(813) 654-4545
(813) 654-3470
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
8712
FL
Other
Enumeration date
07/23/2006
Last updated
07/16/2008
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