MICHAEL D. MELLUM

PORTLAND, OR
NPI1861481848
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy1223G0001X Dentist, General Practice
(Licence: OR  4750)
Enumeration Date2005-10-21
Last Update Date2007-07-08
Business Address
Dr. MICHAEL D. MELLUM D.M.D.
8910 N KELLOGG ST
PORTLAND, OR 97203-3002
Phone number: 503-286-4492
Mailing Address
Dr. MICHAEL D. MELLUM D.M.D.
8910 N KELLOGG ST
PORTLAND, OR 97203-3002
Phone number: 503-286-4492
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