Mary B Medige

NPI #1598372476 in Peterson Afb, Colorado

Provider Information

NPI Number: 1598372476
Entity Type: Individual
Name: Mary B Medige
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Dental Assistant
Enumeration Date: Sep 25, 2020
Last Updated: Sep 25, 2020

Practice Location

Address: 21 DENTAL SQUADRON/SGDD
Address 2: 1055 E. STEWART BLDG 2018
City: Peterson Afb
State: Colorado
ZIP Code: 80925
Phone: (719) 566-1333

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dental Assistant	126800000X	Primary

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