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Individual

MELANIE PAIGE-BROWN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
989 ELLIS AVE, JACKSON, MS 39209-6256
(601) 354-3557
Mailing address
989 ELLIS AVE, JACKSON, MS 39209
(601) 354-3557
(601) 354-7191

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
2743
MS
1223G0001X
General Practice Dentistry
Primary
2743-93
MS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00660236
MS
Enumeration date
06/08/2006
Last updated
07/21/2022
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