Organization
PETE N MELLAS DMD MS PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PETE NICHOLAS MELLAS DMD (OWNER)
(602) 404-4458
Entity
Organization
Contact information
Practice address
4910 E GREENWAY RD STE 2, SCOTTSDALE, AZ 85254-1653
(602) 404-4458
Mailing address
4910 E GREENWAY RD STE 2, SCOTTSDALE, AZ 85254-1653
(602) 404-4458
Taxonomy
Speciality
Code
Description
License number
State
1223P0300X
Periodontics
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1316947963
NPI TYPE 1
AZ
Enumeration date
12/11/2018
Last updated
12/11/2018
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