Individual
DR. MELVIN G. MITCHELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
704 S BROADWAY, SUITE 1, PORTLAND, TN 37148-1674
(615) 325-9837
Mailing address
704 S BROADWAY, SUITE 1, PORTLAND, TN 37148-1674
(615) 325-9837
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DS2934
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0192607
BC/BS
TN
05
—
3202641
—
TN
Enumeration date
07/24/2006
Last updated
07/08/2007
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