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Individual
ERICK VINES
Active
Individual
ERICK VINES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LD
Taxonomy
Speciality
Code
Description
License number
State
122400000X
Denturist
Primary
27
MT
Other
Enumeration date
11/08/2010
Last updated
11/08/2010
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