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Individual
EDDIE MORALES
Active
Individual
EDDIE MORALES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Taxonomy
Speciality
Code
Description
License number
State
1223P0300X
Periodontics
Primary
7160-15
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
ENROLLED
—
MN
Enumeration date
06/23/2010
Last updated
11/05/2013
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