Individual
JENNIFER LYNN MIEDEMA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
1 VA CTR, AUGUSTA, ME 04330-6719
(207) 623-8411
Mailing address
37 NORTHWOOD RD, WEST BATH, ME 04530-6625
(207) 751-8577
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
4576
ME
Other
Enumeration date
06/26/2017
Last updated
06/26/2017
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