Individual
MRS. LAUREL NICOLE MEDINA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RDH
Contact information
Practice address
1635 BLUE SPRUCE DR, FORT COLLINS, CO 80524-5427
(970) 484-0999
Mailing address
1048 STRACHAN DR, FORT COLLINS, CO 80525-2222
(970) 420-4910
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
DH.000905616
CO
Other
Enumeration date
03/18/2020
Last updated
03/18/2020
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