Provider Demographics
NPI:1821213109
Name:RINCK, MELISSA EMILY (DDS)
Entity Type:Individual
Prefix:
First Name:MELISSA
Middle Name:EMILY
Last Name:RINCK
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 1:750 LAS GALLINAS AVE
Mailing Address - Street 2:SUITE 215
Mailing Address - City:SAN RAFAEL
Mailing Address - State:CA
Mailing Address - Zip Code:94903-3438
Mailing Address - Country:US
Mailing Address - Phone:415-479-4977
Mailing Address - Fax:415-479-5043
Practice Address - Street 1:750 LAS GALLINAS AVE
Practice Address - Street 2:SUITE 215
Practice Address - City:SAN RAFAEL
Practice Address - State:CA
Practice Address - Zip Code:94903-3438
Practice Address - Country:US
Practice Address - Phone:415-479-4977
Practice Address - Fax:415-479-5043
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA37730122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist