Provider Demographics
NPI:1447253430
Name:ANDREWS, MELANIE (DDS)
Entity type:Individual
Prefix:
First Name:MELANIE
Middle Name:
Last Name:ANDREWS
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:103 PLANTATION ROAD
Mailing Address - Street 2:
Mailing Address - City:DESTREHAN
Mailing Address - State:LA
Mailing Address - Zip Code:70047-3811
Mailing Address - Country:US
Mailing Address - Phone:985-764-1148
Mailing Address - Fax:985-725-1877
Practice Address - Street 1:103 PLANTATION RD
Practice Address - Street 2:
Practice Address - City:DESTREHAN
Practice Address - State:LA
Practice Address - Zip Code:70047-3016
Practice Address - Country:US
Practice Address - Phone:985-764-1148
Practice Address - Fax:985-725-1877
Is Sole Proprietor?:Yes
Enumeration Date:2005-05-23
Last Update Date:2011-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA38001223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice