| Michael D. Mellum, Dmd Pc | |
|
8910 N Kellogg St Portland OR 97203-3002 | |
| (503) 286-4492 | |
| Not Available |
| Full Name | Michael D. Mellum, Dmd Pc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 8910 N Kellogg St, Portland, Oregon |
| Authorized Official Name and Position | Michael Deane Mellum (PRESIDENT) |
| Authorized Official Contact | 5032864492 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Michael D. Mellum, Dmd Pc 8910 N Kellogg St Portland OR 97203-3002 Ph: (503) 286-4492 | Michael D. Mellum, Dmd Pc 8910 N Kellogg St Portland OR 97203-3002 Ph: (503) 286-4492 |
| NPI Number | 1407062128 |
|---|---|
| Provider Enumeration Date | 05/16/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1407062128 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
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