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Individual
MATTHEW CARBAJAL
Active
Individual
MATTHEW CARBAJAL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
D011158
AZ
390200000X
Student in an Organized Health Care Education/Training Program
Primary
2951000934
MI
Other
Enumeration date
03/30/2020
Last updated
06/23/2023
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