Individual
JORGE MADAMBA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
304 S AIR DEPOT BLVD, MIDWEST CITY, OK 73110-4433
(405) 733-0002
(405) 741-2230
Mailing address
555 W BENJAMIN HOLT DR, BUILDING B, STOCKTON, CA 95207-3839
(209) 476-4700
(209) 478-6890
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
3173
OK
Other
Enumeration date
06/14/2006
Last updated
06/26/2008
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