Organization
ERNEST S. MELANSON, DDS,MS,PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ERNEST S. MELANSON DDS, MS (PRESIDENT)
(508) 755-2207
Entity
Organization
Contact information
Practice address
10 WINTHROP ST, WORCESTER, MA 01604-4435
(508) 755-2207
(508) 755-2275
Mailing address
10 WINTHROP ST, WORCESTER, MA 01604-4435
(508) 755-2207
(508) 755-2275
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
10787
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0210161
—
MA
05
—
9733043
—
MA
01
—
V04647
BLUE CROSS BLUE SHIELD
MA
Enumeration date
01/18/2007
Last updated
08/22/2020
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