Individual
MARK MIEDEMA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
TOGUS VA HOSPITAL, 1 VA CENTER, TOGUS, ME 04330
(207) 623-8411
Mailing address
37 NORTHWOOD RD, WEST BATH, ME 04530-6625
(207) 442-9706
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
3535
ME
Other
Enumeration date
08/29/2006
Last updated
07/08/2007
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