Provider Demographics
NPI:1669431474
Name:MELVIN, JAMES B III (DMD)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:B
Last Name:MELVIN
Suffix:III
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:7001 HODGSON MEMORIAL DR STE 4
Mailing Address - Street 2:
Mailing Address - City:SAVANNAH
Mailing Address - State:GA
Mailing Address - Zip Code:31406-2549
Mailing Address - Country:US
Mailing Address - Phone:912-355-1307
Mailing Address - Fax:912-355-1360
Practice Address - Street 1:7001 HODGSON MEMORIAL DR STE 4
Practice Address - Street 2:
Practice Address - City:SAVANNAH
Practice Address - State:GA
Practice Address - Zip Code:31406-2549
Practice Address - Country:US
Practice Address - Phone:912-355-1307
Practice Address - Fax:912-355-1360
Is Sole Proprietor?:No
Enumeration Date:2006-03-21
Last Update Date:2007-10-10
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GADN0129721223D0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223D0001XDental ProvidersDentistDental Public Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA112831348AMedicaid