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Contact Information

MELINDA H HACKER, DDS
710 AVE E
CARRIZOZO, NM88301-0008
 Phone: 575-648-2839
 Fax: 505-648-4113
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Dentist

122300000X
Indicates primary specialty

NPI Profile & details for MELINDA H HACKER · (Female)

NPI # 1417982141
Status Active
Credentials DDS (Doctor of Dental Surgery)
Entity Individual
Enumeration date 07/11/2006
Last updated 09/28/2021 - About 5 years ago
Sole proprietor 1 No
Identifiers
  • NM License # DD2688
  • NM Medicaid PENDING
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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