Individual
MELISSA O'DELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1904 LYNNE LN NW, GRAND RAPIDS, MI 49504-6029
(616) 734-1671
Mailing address
1904 LYNNE LN NW, GRAND RAPIDS, MI 49504-6029
(616) 734-1671
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
2902013027
MI
Other
Enumeration date
12/01/2015
Last updated
12/01/2015
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