Provider Demographics
NPI:1225184575
Name:MEL GINEST, DDS, PC
Entity type:Organization
Organization Name:MEL GINEST, DDS, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT, OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MELVIN
Authorized Official - Middle Name:NEIL
Authorized Official - Last Name:GINEST
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:307-754-5502
Mailing Address - Street 1:215 S DIVISION ST
Mailing Address - Street 2:
Mailing Address - City:POWELL
Mailing Address - State:WY
Mailing Address - Zip Code:82435-2512
Mailing Address - Country:US
Mailing Address - Phone:307-754-5502
Mailing Address - Fax:307-754-4289
Practice Address - Street 1:215 S DIVISION ST
Practice Address - Street 2:
Practice Address - City:POWELL
Practice Address - State:WY
Practice Address - Zip Code:82435-2512
Practice Address - Country:US
Practice Address - Phone:307-754-5502
Practice Address - Fax:307-754-4289
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-26
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WY6921223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty