NPI | 1669642963 |
---|---|
Doing Business As | MARYKNOLL DENTAL OFFICE OF MARILOU P. MEDINA, DMD, INC. |
Entity Type | Organization |
Authorized Contact | MARILOU PANGANIBAN MEDINA Dentist 909-355-6400 |
Organization Subpart ? | No |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CA 44340) |
Enumeration Date | 2008-03-03 |
Last Update Date | 2020-12-15 |