Provider Demographics
NPI:1245248350
Name:MELTON, FREDERICK T (DDS)
Entity type:Individual
Prefix:
First Name:FREDERICK
Middle Name:T
Last Name:MELTON
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 1:1008 5TH ST.
Mailing Address - Street 2:FRED MELTON, DDS, PLLC
Mailing Address - City:WENATCHEE
Mailing Address - State:WA
Mailing Address - Zip Code:98801-1823
Mailing Address - Country:US
Mailing Address - Phone:509-662-8815
Mailing Address - Fax:509-667-8725
Practice Address - Street 1:1008 5TH ST.
Practice Address - Street 2:
Practice Address - City:WENATCHEE
Practice Address - State:WA
Practice Address - Zip Code:98801-1823
Practice Address - Country:US
Practice Address - Phone:509-662-8815
Practice Address - Fax:509-667-8725
Is Sole Proprietor?:No
Enumeration Date:2006-08-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA61351223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice