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Individual
MATTHEW STEPHEN PACKARD
Active
Individual
MATTHEW STEPHEN PACKARD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
60498
CA
Other
Enumeration date
07/14/2011
Last updated
07/14/2011
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