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Individual
ANASTASIA MOSPANOVA
Active
Individual
ANASTASIA MOSPANOVA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DDS
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
019032426
IL
122300000X
Dentist
Primary
D11327
OR
Other
Enumeration date
11/05/2019
Last updated
10/06/2020
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