Provider Demographics
NPI:1831594209
Name:MELNER, GENE (DPD)
Entity type:Individual
Prefix:DR
First Name:GENE
Middle Name:
Last Name:MELNER
Suffix:
Gender:M
Credentials:DPD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7411 196TH ST SW
Mailing Address - Street 2:
Mailing Address - City:LYNNWOOD
Mailing Address - State:WA
Mailing Address - Zip Code:98036-5052
Mailing Address - Country:US
Mailing Address - Phone:425-678-1166
Mailing Address - Fax:425-678-1167
Practice Address - Street 1:7411 196TH ST SW
Practice Address - Street 2:
Practice Address - City:LYNNWOOD
Practice Address - State:WA
Practice Address - Zip Code:98036-5052
Practice Address - Country:US
Practice Address - Phone:425-678-1166
Practice Address - Fax:425-678-1167
Is Sole Proprietor?:No
Enumeration Date:2014-10-28
Last Update Date:2018-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADN60457532122400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122400000XDental ProvidersDenturist