Individual
ARLEY MEDRANO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS, MS
Contact information
Practice address
711 S CLAY ST STE A, ENNIS, TX 75119-5748
(972) 875-5437
Mailing address
2422 GLENGARIFF DR, DALLAS, TX 75228-2934
(509) 322-5320
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
DE60884780
WA
1223P0221X
Pediatric Dentistry
Primary
39259
TX
1223P0221X
Pediatric Dentistry
DE60884780
WA
Other
Enumeration date
08/27/2018
Last updated
05/26/2023
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