Provider Demographics
NPI:1225430887
Name:CAMERA, MELANIE (RDH)
Entity Type:Individual
Prefix:
First Name:MELANIE
Middle Name:
Last Name:CAMERA
Suffix:
Gender:F
Credentials:RDH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:202 CHESTNUT ST
Mailing Address - Street 2:
Mailing Address - City:ELYRIA
Mailing Address - State:OH
Mailing Address - Zip Code:44035-5325
Mailing Address - Country:US
Mailing Address - Phone:440-284-1562
Mailing Address - Fax:440-284-1558
Practice Address - Street 1:202 CHESTNUT ST
Practice Address - Street 2:
Practice Address - City:ELYRIA
Practice Address - State:OH
Practice Address - Zip Code:44035-5325
Practice Address - Country:US
Practice Address - Phone:440-284-1562
Practice Address - Fax:440-284-1558
Is Sole Proprietor?:No
Enumeration Date:2014-09-25
Last Update Date:2014-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH31014623124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist