| NPI | 1043660079 |
|---|---|
| Former Name | MELISSALYNN LAURON DIXON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: OR D10446) |
| Additional Taxonomies | 122300000X Dentist (Licence: FL DN21856) |
| Enumeration Date | 2016-06-21 |
| Last Update Date | 2021-03-19 |