Provider Demographics
NPI:1013224229
Name:PAULI, MELISSA NICOLE (DMD)
Entity Type:Individual
Prefix:DR
First Name:MELISSA
Middle Name:NICOLE
Last Name:PAULI
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:BLDG 3089, D STREET
Mailing Address - Street 2:21ST DENTAL COMPANY, MARINE CORPS BASE HAWAII
Mailing Address - City:KANEOHE BAY
Mailing Address - State:HI
Mailing Address - Zip Code:96863-3037
Mailing Address - Country:US
Mailing Address - Phone:808-257-3100
Mailing Address - Fax:
Practice Address - Street 1:BLDG 3089, D STREET
Practice Address - Street 2:21ST DENTAL COMPANY, MARINE CORPS BASE HAWAII
Practice Address - City:KANEOHE BAY
Practice Address - State:HI
Practice Address - Zip Code:96863-3037
Practice Address - Country:US
Practice Address - Phone:808-257-3100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-09-09
Last Update Date:2010-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0401412947122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist