Provider Demographics
NPI:1477502177
Name:MELE, MARK J (DMD)
Entity Type:Individual
Prefix:DR
First Name:MARK
Middle Name:J
Last Name:MELE
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
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Mailing Address - Street 1:2826 MOUNT CARMEL AVE
Mailing Address - Street 2:
Mailing Address - City:GLENSIDE
Mailing Address - State:PA
Mailing Address - Zip Code:19038-2245
Mailing Address - Country:US
Mailing Address - Phone:215-886-7880
Mailing Address - Fax:215-886-0848
Practice Address - Street 1:2826 MOUNT CARMEL AVE
Practice Address - Street 2:
Practice Address - City:GLENSIDE
Practice Address - State:PA
Practice Address - Zip Code:19038-2245
Practice Address - Country:US
Practice Address - Phone:215-886-7880
Practice Address - Fax:215-886-0848
Is Sole Proprietor?:No
Enumeration Date:2006-05-09
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
PADS027434-L1223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics