Provider Demographics
NPI:1225854615
Name:THOMAS S MELANSON DDS LLC
Entity type:Organization
Organization Name:THOMAS S MELANSON DDS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:S
Authorized Official - Last Name:MELANSON
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:443-604-5853
Mailing Address - Street 1:108 MOUNT CARMEL RD
Mailing Address - Street 2:
Mailing Address - City:PARKTON
Mailing Address - State:MD
Mailing Address - Zip Code:21120-9723
Mailing Address - Country:US
Mailing Address - Phone:443-604-5853
Mailing Address - Fax:
Practice Address - Street 1:108 MOUNT CARMEL RD
Practice Address - Street 2:
Practice Address - City:PARKTON
Practice Address - State:MD
Practice Address - Zip Code:21120-9723
Practice Address - Country:US
Practice Address - Phone:410-329-2118
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-12-02
Last Update Date:2024-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental