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Individual
PRIYANKA JAIN
Active
Individual
PRIYANKA JAIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DMD
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
019030519
IL
Other
Enumeration date
11/19/2015
Last updated
11/19/2015
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