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Organization
MARILOU P. MEDINA, DMD, INC.
Active
Organization
MARILOU P. MEDINA, DMD, INC.
Active
Other names
Maryknoll Dental Office Of Marilou P. Medina, DMD, Inc.
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARILOU PANGANIBAN MEDINA DMD (DENTIST)
(909) 355-6400
Entity
Organization
Contact information
Practice address
14451 FOOTHILL BLVD., SUITE 104, FONTANA, CA 92335
(909) 355-6400
(909) 355-6411
Mailing address
14451 FOOTHILL BLVD., SUITE 104, FONTANA, CA 92335
(909) 355-6400
(909) 355-6411
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
44340
CA
Other
Enumeration date
03/03/2008
Last updated
12/15/2020
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