Provider Demographics
NPI:1316413636
Name:SALON BABYGIRLS HAIR REPLACEMENT CENTER
Entity Type:Organization
Organization Name:SALON BABYGIRLS HAIR REPLACEMENT CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:MELVA
Authorized Official - Middle Name:
Authorized Official - Last Name:DIXON
Authorized Official - Suffix:
Authorized Official - Credentials:MASTER SENIOR STYLIS
Authorized Official - Phone:301-583-6535
Mailing Address - Street 1:6118 SEA LION PL
Mailing Address - Street 2:
Mailing Address - City:WALDORF
Mailing Address - State:MD
Mailing Address - Zip Code:20603-4448
Mailing Address - Country:US
Mailing Address - Phone:301-583-6535
Mailing Address - Fax:
Practice Address - Street 1:6310 MARLBORO PIKE
Practice Address - Street 2:
Practice Address - City:DISTRICT HEIGHTS
Practice Address - State:MD
Practice Address - Zip Code:20747-2805
Practice Address - Country:US
Practice Address - Phone:240-838-5811
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-10-15
Last Update Date:2018-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1744P3200XOther Service ProvidersSpecialistProsthetics Case ManagementGroup - Single Specialty