Provider Demographics
NPI:1235250028
Name:FORRISTER, MELANIE R (DDS,MS)
Entity Type:Individual
Prefix:DR
First Name:MELANIE
Middle Name:R
Last Name:FORRISTER
Suffix:
Gender:F
Credentials:DDS,MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4396 E US HIGHWAY 64
Mailing Address - Street 2:
Mailing Address - City:MURPHY
Mailing Address - State:NC
Mailing Address - Zip Code:28906-7912
Mailing Address - Country:US
Mailing Address - Phone:828-835-3128
Mailing Address - Fax:828-835-8101
Practice Address - Street 1:4396 E US HIGHWAY 64
Practice Address - Street 2:
Practice Address - City:MURPHY
Practice Address - State:NC
Practice Address - Zip Code:28906-7912
Practice Address - Country:US
Practice Address - Phone:828-835-3128
Practice Address - Fax:828-835-8101
Is Sole Proprietor?:No
Enumeration Date:2007-04-02
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC61371223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8990146Medicaid