Individual
MELANIE MERRIAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RDH
Contact information
Practice address
100 INTREPID LN, SYRACUSE, NY 13205-2546
(315) 492-8138
(315) 492-6169
Mailing address
4152 GATES RD, JAMESVILLE, NY 13078-9624
(315) 682-7881
(315) 492-6169
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
016947-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
016947-1
RDH LICENSE #
NY
Enumeration date
02/26/2007
Last updated
07/08/2007
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