Individual
STEPHEN MARK MEDIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
509 16TH AVE SW, WILLMAR, MN 56201-4118
(320) 235-7742
(320) 235-4045
Mailing address
509 16TH AVE SW, WILLMAR, MN 56201-4118
(320) 235-7742
(320) 235-4045
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
8655
MN
Other
Enumeration date
11/16/2006
Last updated
06/06/2012
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