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Individual
DR. TARA VATTADI
Active
Individual
DR. TARA VATTADI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
019032705
IL
122300000X
Dentist
Primary
107043
CA
Other
Enumeration date
03/26/2020
Last updated
11/17/2021
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