Individual
ALICIA T MEDRANO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RDH
Contact information
Practice address
1105 GOLF COURSE RD SE BLDG A, RIO RANCHO, NM 87124-4733
(505) 891-3190
Mailing address
1105 GOLF COURSE RD SE BLDG A, RIO RANCHO, NM 87124-4733
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
DH4112
NM
Other
Enumeration date
05/22/2018
Last updated
05/22/2018
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