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Individual
MISS AMANDA R. MEDINA
Active
Individual
MISS AMANDA R. MEDINA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DENTAL ASSISTANT
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
00845
OH
126800000X
Dental Assistant
Primary
00845
OH
Other
Enumeration date
06/15/2009
Last updated
06/15/2009
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