Provider Demographics
NPI:1851825269
Name:DIGGAN, MELINDA (PHDHP)
Entity Type:Individual
Prefix:
First Name:MELINDA
Middle Name:
Last Name:DIGGAN
Suffix:
Gender:F
Credentials:PHDHP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:631 RED HILL RD
Mailing Address - Street 2:
Mailing Address - City:MILTON
Mailing Address - State:PA
Mailing Address - Zip Code:17847-7556
Mailing Address - Country:US
Mailing Address - Phone:570-713-9271
Mailing Address - Fax:
Practice Address - Street 1:631 RED HILL RD
Practice Address - Street 2:
Practice Address - City:MILTON
Practice Address - State:PA
Practice Address - Zip Code:17847-7556
Practice Address - Country:US
Practice Address - Phone:570-713-9271
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-04-13
Last Update Date:2017-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADH013140L124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist