Individual
BRODERICK WAYNE MELLING
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
9777 BERMUDA RD STE 100, LAS VEGAS, NV 89183-3571
(702) 699-5551
Mailing address
10336 HAWK RAVINE ST, LAS VEGAS, NV 89178-3531
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
7382
NV
Other
Enumeration date
07/21/2020
Last updated
07/21/2020
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