Provider Demographics
NPI:1962895409
Name:LEE, MELANIE LOVE (DMD)
Entity type:Individual
Prefix:DR
First Name:MELANIE
Middle Name:LOVE
Last Name:LEE
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 1:90 SADDLE WAY UNIT 400
Mailing Address - Street 2:
Mailing Address - City:CHESTERFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:08515-2949
Mailing Address - Country:US
Mailing Address - Phone:609-372-2210
Mailing Address - Fax:609-372-2211
Practice Address - Street 1:90 SADDLE WAY UNIT 400
Practice Address - Street 2:
Practice Address - City:CHESTERFIELD
Practice Address - State:NJ
Practice Address - Zip Code:08515-2949
Practice Address - Country:US
Practice Address - Phone:609-372-2210
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-03-09
Last Update Date:2024-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22DI02595500122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist