Provider Demographics
NPI:1871127811
Name:HEBERT, MELANIE NICOLE (DDS)
Entity type:Individual
Prefix:DR
First Name:MELANIE
Middle Name:NICOLE
Last Name:HEBERT
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 1:400 W CAMERON AVE
Mailing Address - Street 2:
Mailing Address - City:CHAPEL HILL
Mailing Address - State:NC
Mailing Address - Zip Code:27516-2707
Mailing Address - Country:US
Mailing Address - Phone:207-703-8530
Mailing Address - Fax:
Practice Address - Street 1:263 FARMINGTON AVE
Practice Address - Street 2:
Practice Address - City:FARMINGTON
Practice Address - State:CT
Practice Address - Zip Code:06032-1956
Practice Address - Country:US
Practice Address - Phone:860-679-2207
Practice Address - Fax:860-679-1363
Is Sole Proprietor?:No
Enumeration Date:2020-02-28
Last Update Date:2023-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT12743390200000X
TX39445122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program