Basic Information
| Provider Information | |||||||||
| NPI: | 1316971898 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | MELCER | ||||||||
| FirstName: | SAMUEL | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | D.M.D | ||||||||
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| Mailing Information | |||||||||
| Address1: | 70 GLORIA DR | ||||||||
| Address2: | |||||||||
| City: | ALLENDALE | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 074011335 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2018252078 | ||||||||
| FaxNumber: | 2018183035 | ||||||||
| Practice Location | |||||||||
| Address1: | 385 TREMONT AVE. | ||||||||
| Address2: | VANJHCS (DENTAL SERVICE - 160) | ||||||||
| City: | E. ORANGE | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 07018 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9736761000 | ||||||||
| FaxNumber: | 9733957019 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/10/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 122300000X | NJ | Y | Dental Providers | Dentist |
No ID Information.