Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 122400000X | Denturist | DN60457532 | WA |
NPI | 1831594209 |
---|---|
Provider Name | Dr. Gene Melner |
First Address | Lynnwood, WA 98036-5052 |
Second Address | Lynnwood, WA 98036-5052 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/10/2014 |
Last Update Date | 04/01/2018 |