Individual
ERIN MEDINA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
7510 E GRAND AVE APT 1304, DALLAS, TX 75214-4163
(903) 799-0553
Mailing address
7510 E GRAND AVE APT 1304, DALLAS, TX 75214-4163
(903) 799-0553
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
36404
TX
Other
Enumeration date
07/26/2020
Last updated
07/27/2020
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