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148 State Route 775 Proctorville OH 45669-8839 | |
(740) 886-7000 | |
(740) 886-5518 |
Full Name | |
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Speciality | Dentist - General Practice |
Location | 148 State Route 775, Proctorville, Ohio |
Authorized Official Name and Position | Melanie Lynn Blevins (DENTIST/OWNER) |
Authorized Official Contact | 7408867000 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Po Box 459 Proctorville OH 45669-0459 Ph: (740) 886-7000 | 148 State Route 775 Proctorville OH 45669-8839 Ph: (740) 886-7000 |
NPI Number | 1053409490 |
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Provider Enumeration Date | 10/11/2006 |
Last Update Date | 08/22/2020 |
Identifier | Type | State | Issuer |
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1053409490 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
1223G0001X | Dentist - General Practice | 21386 (Ohio) | Primary |
1223G0001X | Dentist - General Practice | 3484 (West Virginia) | Secondary |