Melissa Mae Moutray
Oral & Maxillofacial Surgeon
311 Campus Drive Suite 101
Garden City
, Kansas 67846
Melissa Mae Moutray
Oral & Maxillofacial Surgeon
311 Campus Drive Suite 101
Garden City
, Kansas 67846
(620) 271-0160
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About
Features
Specialties
- Oral & Maxillofacial Surgeon
Languages spoken
- English
Location
First Address
- Melissa Mae Moutray
- 311 Campus Drive Suite 101
- Garden City, KS
- Zip : 67846
- Fax : (620) 271-0160
- Phone : (602) 272-0100
Second Address
- Melissa Mae Moutray
- 311 Campus Drive Suite 101
- Garden City, KS
- Zip : 67846
- Fax : (620) 271-0160
- Phone : (602) 272-0100
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 204E00000X | Oral & Maxillofacial Surgeon | 04-41292 | KS |
| N | 204E00000X | Oral & Maxillofacial Surgeon | D1107 | SD |
National Provider Identifier
| NPI | 1386963718 |
|---|---|
| Provider Name | Melissa Mae Moutray |
| First Address | Garden City, KS 67846 |
| Second Address | Garden City, KS 67846 |
| Gender | F |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 25/05/2010 |
| Last Update Date | 15/07/2021 |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.