Provider Demographics
NPI:1548280985
Name:ROBERT H MELTON, DDS, PC
Entity type:Organization
Organization Name:ROBERT H MELTON, DDS, PC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:H
Authorized Official - Last Name:MELTON
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:918-352-3312
Mailing Address - Street 1:PO BOX 712
Mailing Address - Street 2:
Mailing Address - City:DRUMRIGHT
Mailing Address - State:OK
Mailing Address - Zip Code:74030
Mailing Address - Country:US
Mailing Address - Phone:918-352-3312
Mailing Address - Fax:918-352-2681
Practice Address - Street 1:1226 W BROADWAY
Practice Address - Street 2:
Practice Address - City:DRUMRIGHT
Practice Address - State:OK
Practice Address - Zip Code:74030
Practice Address - Country:US
Practice Address - Phone:918-352-3312
Practice Address - Fax:918-352-2681
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-20
Last Update Date:2008-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK100117190BMedicaid