| NPI | 1528807708 |
|---|---|
| Doing Business As | CLETUS A FONMEDIG DDS LLC |
| Entity Type | Organization |
| Authorized Contact | CLETUS FONMEDIG Member 301-437-7749 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Enumeration Date | 2024-05-20 |
| Last Update Date | 2024-05-20 |