Provider Demographics
NPI:1386484269
Name:MELAND, ERIC W (DDS)
Entity type:Individual
Prefix:
First Name:ERIC
Middle Name:W
Last Name:MELAND
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 1:1502 34TH AVE SE
Mailing Address - Street 2:
Mailing Address - City:MINOT
Mailing Address - State:ND
Mailing Address - Zip Code:58701-2971
Mailing Address - Country:US
Mailing Address - Phone:701-740-7777
Mailing Address - Fax:
Practice Address - Street 1:1600 2ND AVE SW STE 24
Practice Address - Street 2:
Practice Address - City:MINOT
Practice Address - State:ND
Practice Address - Zip Code:58701-3459
Practice Address - Country:US
Practice Address - Phone:701-838-8399
Practice Address - Fax:701-852-6066
Is Sole Proprietor?:No
Enumeration Date:2024-05-29
Last Update Date:2024-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND2505122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist