Basic Information
| Provider Information | |||||||||
| NPI: | 1902067606 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | CAMPESE | ||||||||
| FirstName: | MELANIE | ||||||||
| MiddleName: | CATHERINE | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | D.M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 100 E NEWTON ST | ||||||||
| Address2: | BOSTON UNIVERSITY SCHOOL OF DENTAL MEDICINE, 2ND FLOOR | ||||||||
| City: | BOSTON | ||||||||
| State: | MA | ||||||||
| PostalCode: | 021182308 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6176384750 | ||||||||
| FaxNumber: | 6176386170 | ||||||||
| Practice Location | |||||||||
| Address1: | 100 E NEWTON ST | ||||||||
| Address2: | BOSTON UNIVERSITY SCHOOL OF DENTAL MEDICINE, 2ND FLOOR | ||||||||
| City: | BOSTON | ||||||||
| State: | MA | ||||||||
| PostalCode: | 021182308 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6176384750 | ||||||||
| FaxNumber: | 6176386170 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/24/2008 | ||||||||
| LastUpdateDate: | 06/24/2008 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1223P0300X | 9677 | MA | Y | Dental Providers | Dentist | Periodontics |
No ID Information.