Nick R. Mellum Dmd PC

NPI #1013281484 in Portland, Oregon

Provider Information

NPI Number: 1013281484
Entity Type: Organization
Organization Name: Nick R. Mellum Dmd PC
Primary Specialty: Dentist - General Practice
Enumeration Date: Mar 2, 2012
Last Updated: Mar 2, 2012

Practice Location

Address: 8910 N KELLOGG ST
City: Portland
State: Oregon
ZIP Code: 97203-3002
Phone: (503) 286-4492

Authorized Official

Name: DR. NICK MELLUM, DMD
Title: DENTIST
Phone: (503) 286-4492

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist - General Practice — General Practice	1223G0001X	Primary

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