Provider Demographics
NPI:1609992411
Name:TUCKER, MELISSA FRENCHETTA (DDS)
Entity Type:Individual
Prefix:DR
First Name:MELISSA
Middle Name:FRENCHETTA
Last Name:TUCKER
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 1:2377 GREELEY RD BLDG 4011
Mailing Address - Street 2:
Mailing Address - City:FORT SAM HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:78234-7730
Mailing Address - Country:US
Mailing Address - Phone:210-221-9946
Mailing Address - Fax:
Practice Address - Street 1:2377 GREELEY RD BLDG 4011
Practice Address - Street 2:
Practice Address - City:FORT SAM HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:78234-7730
Practice Address - Country:US
Practice Address - Phone:210-221-9946
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-22
Last Update Date:2023-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX165491223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice