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Individual

DR. CAITLYN ADDIE MENICUCCI

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
DMD

Contact information

Practice address
3551 ROGER BROOKE DR, JBSA FT SAM HOUSTON, TX 78234-4504
(210) 916-5586
Mailing address
3551 ROGER BROOKE DR, JBSA FT SAM HOUSTON, TX 78234-4504
(210) 916-5586

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
7234
NV
122300000X
Dentist
DT-2860
HI

Other

Enumeration date
08/15/2019
Last updated
06/04/2024
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