Davis, Melissa Lynn

Davis, Melissa Lynn is an individual health care provider with primary practice located at 6226 14Th Ave , Kenosha WI 53143-4413. She recently has 2 registered licenses in different health care specialties including Student, Health Care / Student in an Organized Health Care Education/Training Program, Dental Providers / General Practice. Dental Providers / General Practice is her primary health care specialty. Davis, Melissa Lynn can be contacted via phone (262) 656-0044.

Contact Information

Primary practice address
6226 14Th Ave Kenosha WI 53143-4413
Phone: (262) 656-0044
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Student, Health Care / Student in an Organized Health Care Education/Training Program 390200000X
Student, Health Care / Student in an Organized Health Care Education/Training Program 390200000X Illinois
Dental Providers / General Practice 1223G0001X 1002038 Wisconsin

Profile Details

NPI number 1033649850
LBN Legal business name Davis, Melissa Lynn
Credentials Doctor of Dental Surgery (DDS)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 14th, 2017
Last updated Feb 11th, 2020 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1033649850 NPPES
Wisconsin Other 1002038-15 LICENSE
Wisconsin Other 123456789 LICENSE

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