Provider Demographics
NPI:1114195971
Name:MEHLMAN, TODD (DDS)
Entity Type:Individual
Prefix:DR
First Name:TODD
Middle Name:
Last Name:MEHLMAN
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 1:44 BRYANT'S COUNTRY SQUARE
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:12083
Mailing Address - Country:US
Mailing Address - Phone:518-966-5323
Mailing Address - Fax:518-966-4538
Practice Address - Street 1:44 BRYANT'S COUNTRY SQUARE
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:NY
Practice Address - Zip Code:12083
Practice Address - Country:US
Practice Address - Phone:518-966-5323
Practice Address - Fax:518-966-4538
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-14
Last Update Date:2008-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0374461223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice