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Individual

MARY B MEDIGE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
21 DENTAL SQUADRON/SGDD, 1055 E. STEWART BLDG 2018, PETERSON AFB, CO 80925
(719) 566-1333
Mailing address
21 DENTAL SQUADRON/SGDD, 1055 E. STEWART BLDG 2018, PETERSON AFB, CO 80925
(719) 566-1333

Taxonomy

Speciality
Code
Description
License number
State
126800000X
Dental Assistant
Primary

Other

Enumeration date
09/25/2020
Last updated
09/25/2020
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