Individual
ANA DINA MEDRANO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
763 RIO RANCHO RD STE 120, POMONA, CA 91766-7015
(909) 242-7989
Mailing address
14595 PIEDMONT DR, MORENO VALLEY, CA 92555-5740
(951) 489-8120
(951) 247-1170
Taxonomy
Speciality
Code
Description
License number
State
126800000X
Dental Assistant
Primary
60484
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
60484
—
CA
Enumeration date
05/28/2020
Last updated
05/28/2020
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