Provider Demographics
NPI:1659405116
Name:ALBERS, MELANIE MARIE (DDS)
Entity Type:Individual
Prefix:
First Name:MELANIE
Middle Name:MARIE
Last Name:ALBERS
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:PO BOX 576
Mailing Address - Street 2:
Mailing Address - City:EAGLE
Mailing Address - State:CO
Mailing Address - Zip Code:81631-0576
Mailing Address - Country:US
Mailing Address - Phone:970-328-1116
Mailing Address - Fax:
Practice Address - Street 1:56 MARKET ST, SUITE 5
Practice Address - Street 2:
Practice Address - City:EAGLE
Practice Address - State:CO
Practice Address - Zip Code:81631
Practice Address - Country:US
Practice Address - Phone:970-328-1116
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-15
Last Update Date:2014-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE6364122300000X
MO2009025266122300000X
CO00202284122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist