Provider Demographics
NPI:1811087091
Name:STROMEYER, MELVYN JOSEPH (DDS)
Entity type:Individual
Prefix:DR
First Name:MELVYN
Middle Name:JOSEPH
Last Name:STROMEYER
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:808 S 28TH AVE
Mailing Address - Street 2:
Mailing Address - City:HATTIESBURG
Mailing Address - State:MS
Mailing Address - Zip Code:39402-2601
Mailing Address - Country:US
Mailing Address - Phone:601-264-6597
Mailing Address - Fax:601-264-9264
Practice Address - Street 1:808 S 28TH AVE
Practice Address - Street 2:
Practice Address - City:HATTIESBURG
Practice Address - State:MS
Practice Address - Zip Code:39402-2601
Practice Address - Country:US
Practice Address - Phone:601-264-6597
Practice Address - Fax:601-264-9264
Is Sole Proprietor?:No
Enumeration Date:2006-10-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS1256661223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice