Provider Demographics
NPI:1851373575
Name:ADLER, MELTON ARTHUR (DDS)
Entity Type:Individual
Prefix:DR
First Name:MELTON
Middle Name:ARTHUR
Last Name:ADLER
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4606 UTOPIA PKWY
Mailing Address - Street 2:
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11358-3339
Mailing Address - Country:US
Mailing Address - Phone:718-353-8967
Mailing Address - Fax:718-353-8967
Practice Address - Street 1:4606 UTOPIA PKWY
Practice Address - Street 2:
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11358-3339
Practice Address - Country:US
Practice Address - Phone:718-353-8967
Practice Address - Fax:718-353-8967
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-17
Last Update Date:2013-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY024278122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00288046Medicaid