Provider Demographics
NPI:1780765263
Name:REA, MELISSA HILLHOUSE (DDS)
Entity type:Individual
Prefix:DR
First Name:MELISSA
Middle Name:HILLHOUSE
Last Name:REA
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 1:7450 GRANT VILLAGE DR
Mailing Address - Street 2:APARTMENT A
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63123-1435
Mailing Address - Country:US
Mailing Address - Phone:314-843-4703
Mailing Address - Fax:
Practice Address - Street 1:6451 CHIPPEWA ST
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63109-2104
Practice Address - Country:US
Practice Address - Phone:314-752-7468
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO20060256581223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice