| Provider / Organization | NPI | Date Certified |
|---|---|---|
| ERIN MEDINA | 1134738156 | 2020-07-27 |
Erin Medina is registered with the National Plan and Provider Enumeration System and has been issued an National Provider Identifier (NPI) of 1134738156. Registration indicates Erin Medina is a provider of access to dentists-general services with a specialization in Dental Providers, Dentist (Dental Providers, Dentist) (Dentist, ) (Dental, ) (Dentist, Dental Providers)
| Entity Type | Individual |
| Provider Name | Erin Medina |
| Practice Office Address | 7510 E GRAND AVE APT 1304 DALLAS, TX US |
| Practice Office Telephone | 9037990553 |
| Mailing Address | 7510 E GRAND AVE APT 1304 DALLAS, TX 752144163 US |
| Business Telephone | 9037990553 |
| Code | Practice | License No State |
|---|---|---|
| 122300000X PRIMARY | Access to Dentists-General Dental Providers Dentist Dental Providers Dentist Dentist Dental Dentist Dental Providers | 36404
TX |
| 193400000X SING | Group Code |