Individual
MADELEINE N DOMENECH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
8955 WOOD RD BLDG 14TH, BETHESDA, MD 20889-5628
(301) 295-0065
Mailing address
200 MERCY CIRCLE, CAMP PENDLETON, CA 92055
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
18095
MD
1223G0001X
General Practice Dentistry
Primary
18095
MD
1223P0700X
Prosthodontics
Primary
18095
MD
Other
Enumeration date
06/28/2023
Last updated
08/05/2026
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