Organization
CLETUS A FONMEDIG DDS LLC
Active
Other names
Cletus A Fonmedig DDS LLC
Organization subpart
No
Provider details
NPI number
Authorized official
CLETUS FONMEDIG DDS (MEMBER)
(301) 437-7749
Entity
Organization
Contact information
Practice address
1709 CHESACO AVE, ROSEDALE, MD 21237-1518
(301) 437-7749
Mailing address
1709 CHESACO AVE, ROSEDALE, MD 21237-1518
(410) 866-5550
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
05/20/2024
Last updated
05/20/2024
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