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Individual
LAN SU
Active
Individual
LAN SU
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DMD PHD
Taxonomy
Speciality
Code
Description
License number
State
1223P0106X
Oral and Maxillofacial Pathology Dentistry
Primary
46977
CA
Other
Enumeration date
12/15/2008
Last updated
12/15/2008
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