Maddox, Melissa Jane

Maddox, Melissa Jane is an individual health care provider with primary practice located at 171 Inner Loop Rd , Fort Irwin CA 92310. She recently has only one registered license in Dental Providers / Dental Hygienist, which is considered as her primary health care specialty. Maddox, Melissa Jane can be contacted via phone (999) 999-9999.

Contact Information

Primary practice address
171 Inner Loop Rd Fort Irwin CA 92310
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Dental Hygienist 124Q00000X 28438 California

Profile Details

NPI number 1194197327
LBN Legal business name Maddox, Melissa Jane
Credentials Registered Dental Hygienist (RDH)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 27th, 2015
Last updated May 17th, 2022 - about 2 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 1194197327 NPPES
California Other 28384 REGISTERED DENTAL HYGIENE LICENSE

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