Individual
MAYRA Y CORONA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
7300 N PERIMETER RD, MALMSTROM AFB, MT 59402-6701
(406) 731-2511
Mailing address
7300 N PERIMETER RD, MALMSTROM AFB, MT 59402-6701
(406) 731-2511
Taxonomy
Speciality
Code
Description
License number
State
126800000X
Dental Assistant
Primary
—
—
Other
Enumeration date
09/23/2020
Last updated
09/23/2020
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