Provider Demographics
NPI:1558407387
Name:MELZER, DANIEL G (DMD)
Entity Type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:G
Last Name:MELZER
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:530 FLORIDA AVE
Mailing Address - Street 2:
Mailing Address - City:LYNN HAVEN
Mailing Address - State:FL
Mailing Address - Zip Code:32444-1736
Mailing Address - Country:US
Mailing Address - Phone:850-271-2341
Mailing Address - Fax:850-271-0679
Practice Address - Street 1:530 FLORIDA AVE
Practice Address - Street 2:
Practice Address - City:LYNN HAVEN
Practice Address - State:FL
Practice Address - Zip Code:32444-1736
Practice Address - Country:US
Practice Address - Phone:850-271-2341
Practice Address - Fax:850-271-0679
Is Sole Proprietor?:No
Enumeration Date:2007-01-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN165741223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice