Provider Demographics
NPI:1770564858
Name:ZYK, MELISSA K (DDS)
Entity type:Individual
Prefix:DR
First Name:MELISSA
Middle Name:K
Last Name:ZYK
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:MRS
Other - First Name:MELISSA
Other - Middle Name:K
Other - Last Name:BOREN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DDS
Mailing Address - Street 1:560 E 14TH ST
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:MO
Mailing Address - Zip Code:63090-4535
Mailing Address - Country:US
Mailing Address - Phone:636-390-9991
Mailing Address - Fax:636-390-9985
Practice Address - Street 1:560 E 14TH ST
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:MO
Practice Address - Zip Code:63090-4535
Practice Address - Country:US
Practice Address - Phone:636-390-9991
Practice Address - Fax:636-390-9985
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-07
Last Update Date:2022-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MODE0160621223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice