Provider Demographics
NPI:1669562690
Name:MULE, MERISSA (DDS)
Entity type:Individual
Prefix:
First Name:MERISSA
Middle Name:
Last Name:MULE
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1612 HUGUENOT RD
Mailing Address - Street 2:
Mailing Address - City:MIDLOTHIAN
Mailing Address - State:VA
Mailing Address - Zip Code:23113
Mailing Address - Country:US
Mailing Address - Phone:804-378-9327
Mailing Address - Fax:
Practice Address - Street 1:6510 HARBOUR VIEW CT
Practice Address - Street 2:
Practice Address - City:MIDOTHIAN
Practice Address - State:VA
Practice Address - Zip Code:23112
Practice Address - Country:US
Practice Address - Phone:804-739-6500
Practice Address - Fax:804-319-5666
Is Sole Proprietor?:No
Enumeration Date:2006-10-13
Last Update Date:2024-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA04014111241223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice