Provider Demographics
NPI:1558590984
Name:DAVIS, MELANIE THOMPSON (DMD)
Entity Type:Individual
Prefix:DR
First Name:MELANIE
Middle Name:THOMPSON
Last Name:DAVIS
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:125 POWELL MILL RD
Mailing Address - Street 2:SUITE C
Mailing Address - City:SPARTANBURG
Mailing Address - State:SC
Mailing Address - Zip Code:29301-1589
Mailing Address - Country:US
Mailing Address - Phone:864-574-0788
Mailing Address - Fax:864-576-5359
Practice Address - Street 1:125 POWELL MILL RD
Practice Address - Street 2:SUITE C
Practice Address - City:SPARTANBURG
Practice Address - State:SC
Practice Address - Zip Code:29301-1589
Practice Address - Country:US
Practice Address - Phone:864-574-0788
Practice Address - Fax:864-576-5359
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-07
Last Update Date:2009-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC3783122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist