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309 E 2nd Ave Ellensburg WA 98926-3315 | |
| (509) 201-1051 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 309 E 2nd Ave, Ellensburg, Washington |
| Authorized Official Name and Position | Michelle Lynn Melton (OWNER) |
| Authorized Official Contact | 5099624518 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
Po Box 766 Ellensburg WA 98926-1921 Ph: (509) 962-4518 | 309 E 2nd Ave Ellensburg WA 98926-3315 Ph: (509) 201-1051 |
| NPI Number | 1912688854 |
|---|---|
| Provider Enumeration Date | 07/25/2023 |
| Last Update Date | 02/02/2025 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1912688854 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
| 122400000X | Denturist | (* (Not Available)) | Secondary |
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