Provider Demographics
NPI:1598076564
Name:PARLETTE, MELENA EVANCHO (DDS)
Entity Type:Individual
Prefix:
First Name:MELENA
Middle Name:EVANCHO
Last Name:PARLETTE
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15039 JARRETTSVL PIKE
Mailing Address - Street 2:
Mailing Address - City:MONKTON
Mailing Address - State:MD
Mailing Address - Zip Code:21111-2405
Mailing Address - Country:US
Mailing Address - Phone:570-956-7867
Mailing Address - Fax:
Practice Address - Street 1:100 SPARKS VALLEY RD
Practice Address - Street 2:STE C
Practice Address - City:SPARKS
Practice Address - State:MD
Practice Address - Zip Code:21152-9342
Practice Address - Country:US
Practice Address - Phone:410-771-8200
Practice Address - Fax:410-771-8201
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-24
Last Update Date:2017-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD145001223P0221X, 1223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry