Provider Demographics
NPI:1518458355
Name:CARRIER, MELISSA M (DDS)
Entity Type:Individual
Prefix:
First Name:MELISSA
Middle Name:M
Last Name:CARRIER
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12 NEWMARCH ST
Mailing Address - Street 2:
Mailing Address - City:KITTERY
Mailing Address - State:ME
Mailing Address - Zip Code:03904-1619
Mailing Address - Country:US
Mailing Address - Phone:207-439-3090
Mailing Address - Fax:
Practice Address - Street 1:12 NEWMARCH ST
Practice Address - Street 2:
Practice Address - City:KITTERY
Practice Address - State:ME
Practice Address - Zip Code:03904-1619
Practice Address - Country:US
Practice Address - Phone:207-439-3090
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-05-29
Last Update Date:2019-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEDEN46221223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice