Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223D0001X | Dental Public Health | DN012972 | GA |
NPI | 1669431474 |
---|---|
Provider Name | Dr. James B Melvin III |
First Address | Savannah, GA 31406-2549 |
Second Address | Savannah, GA 31406-2549 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/03/2006 |
Last Update Date | 10/10/2007 |