Provider Demographics
NPI:1154537785
Name:DUPREE, MELISSA L (DDS)
Entity type:Individual
Prefix:
First Name:MELISSA
Middle Name:L
Last Name:DUPREE
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 1:8480 BLUEBONNET BLVD
Mailing Address - Street 2:SUITE E
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70810-2879
Mailing Address - Country:US
Mailing Address - Phone:225-767-4491
Mailing Address - Fax:225-767-4494
Practice Address - Street 1:8480 BLUEBONNET BLVD
Practice Address - Street 2:SUITE E
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70810-2879
Practice Address - Country:US
Practice Address - Phone:225-767-4491
Practice Address - Fax:225-767-4494
Is Sole Proprietor?:No
Enumeration Date:2007-05-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA5796122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist