Dr Melissa Marie Fallon, DDS | |
403 Virginia Ave, Fairmont, WV 26554-2748 | |
(304) 366-3910 | |
(304) 366-5539 |
Full Name | Dr Melissa Marie Fallon |
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Gender | Female |
Speciality | Dentist |
Location | 403 Virginia Ave, Fairmont, West Virginia |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1003047309 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
122300000X | Dentist | 054497-1 (New York) | Secondary |
122300000X | Dentist | 3928 (West Virginia) | Secondary |
122300000X | Dentist | WV3928 (West Virginia) | Primary |
Entity Name | University Pediatric Dentistry Pc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1649389560 PECOS PAC ID: 8628378908 Enrollment ID: O20151119000362 |
Mailing Address | Practice Location Address |
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Dr Melissa Marie Fallon, DDS 516 Cost Ave., Stonewood, WV 26301 Ph: (304) 624-5250 | Dr Melissa Marie Fallon, DDS 403 Virginia Ave, Fairmont, WV 26554-2748 Ph: (304) 366-3910 |
Dr. Kenny H Koay, DDS Dentist Medicare: Not Enrolled in Medicare Practice Location: 17 Oakwood Rd, Fairmont, WV 26554 Phone: 304-366-0411 | |
Dr. Linda Lou Ray, DDS Dentist Medicare: Not Enrolled in Medicare Practice Location: 2012 Pleasant Valley Rd, Fairmont, WV 26554 Phone: 304-368-0342 Fax: 304-368-0341 | |
Dr. Eamonn Cronin, DDS Dentist Medicare: Not Enrolled in Medicare Practice Location: 100 Greenbrier Plz, Fairmont, WV 26554 Phone: 304-366-9833 | |
Dr. Douglas Clark Hannah, DDS Dentist Medicare: Medicare Enrolled Practice Location: 1520 Country Club Rd, Fairmont, WV 26554 Phone: 304-363-9160 Fax: 304-363-3693 | |
Dr. Franklin David Bonasso, DDS Dentist Medicare: Not Enrolled in Medicare Practice Location: 100 Greenbrier Plaza, Fairmont, WV 26554 Phone: 304-366-9833 Fax: 304-366-0658 | |
Dr. John Maroulis, D.D.S. Dentist Medicare: Medicare Enrolled Practice Location: 32 Middletown Rd, Fairmont, WV 26554 Phone: 304-368-1800 |