Arley Medrano, DDS, MS
Dentist, Pediatric Dentistry in Ennis, TX. Individual provider (NPI-1).
NPI number1669953774
StatusActive
Last updated in NPPESMay 26, 2023
Details
- NPI
- 1669953774
- Entity type
- Individual (NPI-1)
- Name
- Arley Medrano
- Credential
- DDS, MS
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Aug 27, 2018
- Certification date
- May 26, 2023
- Last updated
- May 26, 2023
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1223P0221X | Dentist, Pediatric Dentistry | 39259 | TX | Yes |
| 122300000X | Dentist | DE60884780 | WA | |
| 1223P0221X | Dentist, Pediatric Dentistry | DE60884780 | WA |
Practice location
711 S Clay St Ste AEnnis, TX 75119-5748
Phone 972-875-5437
Mailing address
2422 Glengariff DrDallas, TX 75228-2934
Phone 509-322-5320
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