Provider Demographics
NPI:1457873507
Name:MELOTEK, ANN HALEY (DMD)
Entity type:Individual
Prefix:DR
First Name:ANN
Middle Name:HALEY
Last Name:MELOTEK
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:637 17TH ST
Mailing Address - Street 2:
Mailing Address - City:VERO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32960-6236
Mailing Address - Country:US
Mailing Address - Phone:772-567-7451
Mailing Address - Fax:772-567-7451
Practice Address - Street 1:637 17TH ST
Practice Address - Street 2:
Practice Address - City:VERO BEACH
Practice Address - State:FL
Practice Address - Zip Code:32960-6236
Practice Address - Country:US
Practice Address - Phone:772-567-2111
Practice Address - Fax:772-567-7451
Is Sole Proprietor?:No
Enumeration Date:2017-07-11
Last Update Date:2023-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN22588122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist