Provider Demographics
NPI:1861486458
Name:LANG, MELANIE S (MD DDS)
Entity Type:Individual
Prefix:DR
First Name:MELANIE
Middle Name:S
Last Name:LANG
Suffix:
Gender:F
Credentials:MD DDS
Other - Prefix:
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Mailing Address - Street 1:12109 E BROADWAY AVE
Mailing Address - Street 2:BLDG C
Mailing Address - City:SPOKANE VALLEY
Mailing Address - State:WA
Mailing Address - Zip Code:99206-6133
Mailing Address - Country:US
Mailing Address - Phone:509-926-7106
Mailing Address - Fax:509-928-7469
Practice Address - Street 1:12109 E BROADWAY AVE
Practice Address - Street 2:BLDG C
Practice Address - City:SPOKANE VALLEY
Practice Address - State:WA
Practice Address - Zip Code:99206-6133
Practice Address - Country:US
Practice Address - Phone:509-926-7106
Practice Address - Fax:509-928-7469
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-09-09
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
WA8709204E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes204E00000XAllopathic & Osteopathic PhysiciansOral & Maxillofacial Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA5036587Medicaid