Provider Demographics
NPI:1386650232
Name:LIM, MELISSA AU (DDS)
Entity Type:Individual
Prefix:DR
First Name:MELISSA
Middle Name:AU
Last Name:LIM
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
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Mailing Address - Street 1:37070 NEWARK BLVD
Mailing Address - Street 2:SUITE A
Mailing Address - City:NEWARK
Mailing Address - State:CA
Mailing Address - Zip Code:94560-3798
Mailing Address - Country:US
Mailing Address - Phone:510-792-1456
Mailing Address - Fax:510-792-1458
Practice Address - Street 1:37070 NEWARK BLVD
Practice Address - Street 2:SUITE A
Practice Address - City:NEWARK
Practice Address - State:CA
Practice Address - Zip Code:94560-3798
Practice Address - Country:US
Practice Address - Phone:510-792-1456
Practice Address - Fax:510-792-1458
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-31
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CA420301223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice