Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Q00000X | Family Doctor | 7152053-1205 | UT |
N | 208200000X | Surgeon | 7152053-1205 | UT |
N | 208600000X | Surgeon | 7152053-1205 | UT |
NPI | 1013160597 |
---|---|
Provider Name | Dr. Melanie Ann Dance |
First Address | Salt Lake City, UT 84109-4219 |
Second Address | Salt Lake City, UT 84124-1348 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 29/10/2008 |
Last Update Date | 09/12/2019 |