Individual
ADRIAN MEDINA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
1501 DIVISION ST, BALTIMORE, MD 21217-3121
(410) 383-8300
Mailing address
10 PONDEROSA LN, OLD BRIDGE, NJ 08857-3332
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
16177
MD
Other
Enumeration date
08/22/2013
Last updated
07/23/2016
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