Provider Demographics
NPI:1639328305
Name:DANIEL J MELKER,D.D.S.
Entity Type:Organization
Organization Name:DANIEL J MELKER,D.D.S.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:JILL
Authorized Official - Middle Name:A
Authorized Official - Last Name:NORDEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:727-725-0100
Mailing Address - Street 1:28465 U.S. 19 N.
Mailing Address - Street 2:SUITE 204
Mailing Address - City:CLEARWATER
Mailing Address - State:FL
Mailing Address - Zip Code:33761
Mailing Address - Country:US
Mailing Address - Phone:727-725-0100
Mailing Address - Fax:
Practice Address - Street 1:28465 U.S. 19 NORTH
Practice Address - Street 2:SUITE 204
Practice Address - City:CLEARWATER
Practice Address - State:FL
Practice Address - Zip Code:33761
Practice Address - Country:US
Practice Address - Phone:727-725-0100
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-17
Last Update Date:2008-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN60671223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0300XDental ProvidersDentistPeriodonticsGroup - Single Specialty