NPI 1598372476

Mary B Medige

Practitioner Dental Assistant Peterson Afb, CO

Practice location

Address: 21 Dental Squadron/Sgdd 1055 E. Stewart Bldg 2018, Peterson Afb, CO 80925
Phone: (719) 566-1333

Registered specialties

Dental Assistant Primary

Dental Providers Taxonomy 126800000X

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Registry record

NPI: 1598372476
Entity type: Individual
Sex (as registered): Female
NPI issued: 25 Sep 2020
Record last updated: 25 Sep 2020

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.