Provider Demographics
NPI:1114136215
Name:MELKERS, MICHAEL J (DDS)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:J
Last Name:MELKERS
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:930 N MULLAN RD
Mailing Address - Street 2:SUITE 2
Mailing Address - City:SPOKANE VALLEY
Mailing Address - State:WA
Mailing Address - Zip Code:99206-4004
Mailing Address - Country:US
Mailing Address - Phone:509-891-7770
Mailing Address - Fax:509-891-7773
Practice Address - Street 1:930 N MULLAN RD
Practice Address - Street 2:SUITE 2
Practice Address - City:SPOKANE VALLEY
Practice Address - State:WA
Practice Address - Zip Code:99206-4004
Practice Address - Country:US
Practice Address - Phone:509-891-7770
Practice Address - Fax:509-891-7773
Is Sole Proprietor?:No
Enumeration Date:2007-05-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA73371223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice