Individual
DR. RICHARD WAYNE MELLIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD DDS
Contact information
Practice address
3400 W 16TH ST STE 1A, GREELEY, CO 90634-6854
(970) 353-5826
(970) 353-5829
Mailing address
3400 W 16TH ST, STE 1A, GREELEY, CO 80634-6862
(970) 353-5826
(970) 353-5829
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
DENTAL 7167
CO
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
Primary
MEDICAL 37605
CO
Other
Enumeration date
12/08/2006
Last updated
09/11/2025
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