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Melanie A Clary

Dental Hygienist

Dental Providers

PECOS Enrollment

Based on the most recent information from CMS, provider Melanie A Clary does not have current enrollment records in PECOS.

Part B
Medicare Part B
Not Enrolled
HHA
Home Health Agency
Not Enrolled
DME
Durable Medical Equipment
Not Enrolled
PMD
Power Mobility Device
Not Enrolled

CMS last updated its PECOS records yesterday at 12:57 PM.

Profile Details

Provider ID
1063744829
Provider Type
Individual
Full Name
Clary, Melanie A
Title
Ms.
Credential
RDH

Gender
Female
Sole Proprietor
No
Enumeration Date
2/4/2010
Last Updated
2/5/2010

Contact Information

Practice Location

Unit 28038, Apo, AE 09112-5000

(314) 476-4738

Unlisted Fax

Mailing Location

Cmr 459 Box 17911, Apo, AE 09139

Unlisted Phone

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 124Q00000X Primary	Description Dental Hygienist Dental Providers	License 983 Louisiana
Code 124Q00000X	Description Dental Hygienist Dental Providers	License 9203298 Colorado
Code 124Q00000X	Description Dental Hygienist Dental Providers	License 8417 California

Melanie A Clary

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Code

Description

License

Code

Description

License

Mccullough, Tami

Juarez, Irene

Burk, Reinette

Calvin, Debra

Nguyen, Michael

Frankfurt, Krystal

Ebert, Lindsey

Ryan, Amber Marie

Ramirez, Cheryl L

Phan, Tam Minh