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Individual
MAMORU TANAKA
Active
Individual
MAMORU TANAKA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S, FACP
Taxonomy
Speciality
Code
Description
License number
State
1223P0700X
Prosthodontics
Primary
101517
CA
1223P0700X
Prosthodontics
31503
TX
Other
Enumeration date
10/20/2011
Last updated
11/22/2022
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