Provider Demographics
NPI:1407317407
Name:ECKLEY, MELISSA (DDS, MS)
Entity type:Individual
Prefix:
First Name:MELISSA
Middle Name:
Last Name:ECKLEY
Suffix:
Gender:F
Credentials:DDS, MS
Other - Prefix:
Other - First Name:MELISSA
Other - Middle Name:
Other - Last Name:MORAWSKI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DDS, MS
Mailing Address - Street 1:4901 LIMESTONE RD
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19808-1271
Mailing Address - Country:US
Mailing Address - Phone:302-239-4600
Mailing Address - Fax:
Practice Address - Street 1:4901 LIMESTONE RD
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19808-1271
Practice Address - Country:US
Practice Address - Phone:302-239-4600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-03-31
Last Update Date:2024-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEG1-00115411223X0400X
IARES-30603390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics