Provider Demographics
NPI:1457361511
Name:OLIVO HELLER, MELISSA (DMD)
Entity type:Individual
Prefix:
First Name:MELISSA
Middle Name:
Last Name:OLIVO HELLER
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:69 BIRCH PKWY
Mailing Address - Street 2:
Mailing Address - City:SPARTA
Mailing Address - State:NJ
Mailing Address - Zip Code:07871-1225
Mailing Address - Country:US
Mailing Address - Phone:973-518-4668
Mailing Address - Fax:
Practice Address - Street 1:12 TROY HILLS RD
Practice Address - Street 2:
Practice Address - City:WHIPPANY
Practice Address - State:NJ
Practice Address - Zip Code:07981-1501
Practice Address - Country:US
Practice Address - Phone:973-386-0300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-09
Last Update Date:2007-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22DI022669001223G0001X
NY050431-11223G0001X
PADS0371601223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice