Provider Demographics
NPI:1316971898
Name:MELCER, SAMUEL (DMD)
Entity type:Individual
Prefix:DR
First Name:SAMUEL
Middle Name:
Last Name:MELCER
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:70 GLORIA DR
Mailing Address - Street 2:
Mailing Address - City:ALLENDALE
Mailing Address - State:NJ
Mailing Address - Zip Code:07401-1335
Mailing Address - Country:US
Mailing Address - Phone:201-825-2078
Mailing Address - Fax:201-818-3035
Practice Address - Street 1:385 TREMONT AVE.
Practice Address - Street 2:VANJHCS (DENTAL SERVICE - 160)
Practice Address - City:E. ORANGE
Practice Address - State:NJ
Practice Address - Zip Code:07018
Practice Address - Country:US
Practice Address - Phone:973-676-1000
Practice Address - Fax:973-395-7019
Is Sole Proprietor?:No
Enumeration Date:2006-07-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist