DR. Jaqueline Medina, DDS

NPI #1477167419 in Port Arthur, Texas

Provider Information

NPI Number: 1477167419
Entity Type: Individual
Name: DR. Jaqueline Medina, DDS
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Dentist - General Practice
Credential: DDS
Enumeration Date: Sep 8, 2020
Last Updated: Sep 8, 2020

Practice Location

Address: 2780 FM 365
Address 2: SUITE C
City: Port Arthur
State: Texas
ZIP Code: 77640
Phone: (409) 332-4701

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist - General Practice — General Practice	1223G0001X	Primary

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