Individual
MISS AMANDA R. MEDINA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DENTAL ASSISTANT
Contact information
Practice address
1 CHILDRENS PLZ, SUITE 2070, DAYTON, OH 45404-1898
(937) 641-3455
Mailing address
725 PATTERSON RD, APARTMENT #2, DAYTON, OH 45419-4319
(937) 344-4291
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
00845
OH
126800000X
Dental Assistant
Primary
00845
OH
Other
Enumeration date
06/15/2009
Last updated
06/15/2009
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