Organization
KIM R. MELTON, DDS, PHD, P.A.
Active
Other names
Heritage Aesthetic Dentistry
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KIM R MELTON DDS, PHD (PRESIDENT)
(919) 453-2300
Entity
Organization
Contact information
Practice address
3205 ROGERS RD, WAKE FOREST, NC 27587-3805
(909) 453-2300
(919) 453-2301
Mailing address
3205 ROGERS RD, WAKE FOREST, NC 27587-3805
(909) 453-2300
(919) 453-2301
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
7307
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8990174
—
NC
Enumeration date
05/14/2007
Last updated
08/22/2020
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